Peterborough Regional Health Centre is proposing a plan to eliminate 171 full-time equivalent jobs, cut 20 beds, and consolidate services at the new hospital site.
Rally to protect hospital services:
Thursday, June 17 / 5 pm
Millenium Park, Peterborough
Posted in Uncategorized
With professor emeritus Colin Leys & Ontario Health Coalition director Natalie Mehra
When: Saturday, June 19, 2010 / 12:30 – 3:30 pm
Where: OISE (Ontario Institute for Studies in Education) 252 Bloor St. West,
7th Floor, Peace Room
Presentation~Discussion~Strategy Session
Posted in Health System
Video of yesterday’s press conferences in Durham and Kincardine:
DURHAM/KINCARDINE—South Bruce Grey Health Centre is alienating both staff and community as it implements cuts to the four-site hospital in Grey and Bruce counties.
Community and labour groups are calling on the hospital board to listen to community concerns around a plan to dismantle the hospital’s kitchens and truck frozen pre-prepared meals into Ontario’s agricultural heartland.
“Food is such an important component of good health and can assist in the recovery process,” says Natalie Mehra, Director of the Ontario Health Coalition. “There is a growing movement in Canadian and U.S. hospitals towards fresh, local and sustainable foods. To bypass local farmers to bring in the cheapest processed food stripped of many of its nutrients creates waste and diminishes patient comfort and satisfaction.”
“If Paul Davies is expecting to leave a legacy behind, it will be one of chaos and confusion,” says Mary Ellen Pollard, Co-Chair of the Friends of the Kincardine Hospital. “The hospital board cannot ignore the fact that nearly three of every four Kincardine residents polled want to see their hospital taken out of the amalgamated South Bruce Grey Health Centre.”
The Friends group was recently rebuffed by the SBGHC board that ignored their request to a follow-up meeting over a $10,000 consultant’s report on governance commissioned by the community group. The report raises concerns about SBGHC’s board secrecy and the lack of two-way communications with staff and the community.
There is also growing discontent with labour management at the hospital over a botched process to offer exit packages and heavy-handed management tactics aimed at reducing sick days.
Staff morale at SBGHC is failing as the hospital stumbles through a plan to convert support staff into multi-site, multi-purpose workers. Initially expecting to eliminate the equivalent of 15 full-time equivalent jobs, the Centre offered voluntary exits and early retirements to 12 individuals. It has since asked individuals to take back the exit package and is hiring to replace many of the eleven individuals who are being severed at public expense. One employees has agreed to rescind the package.
There are also ethical concerns given the hospital is offering exit packages without an exit date, leaving the eleven workers dangling indefinitely for their severance.
“From a labour-relations standpoint, this is one of the worst hospital employers in Ontario,” says Warren (Smokey) Thomas,President of the Ontario Public Service Employees Union. OPSEU represents administrative and support staff at the hospital. “There have been more than 40 grievances in the last two years, and we expect that figure could double in 2010.”
The union is upset that the hospital is overruling the advice of licensed physicians in making return to work decisions. A staff member who recently underwent surgery was told by her doctor that she shouldn’t return to work for 30 days. The hospital told her she must be back in 10 days.
Dave Trumble, President of the Grey Bruce Labour Council, has pledged support for a coalition campaign to pressure the hospital to listen to the communities it serves and to make peace with its workforce.
OPSEU wrote a letter to the CEO and Board Chair May 3rd offering to sit down and resolve the labour relations difficulties at the hospital. More than a month later the union has received no reply.
The Peterborough Health Coalition hosted a town hall meeting June 3rd to invite members of the public to address the first draft of the regional hospital’s fiscal restraint plan. Given the Orwellian title of a “Hospital Improvement Plan,” the “HIP” calls for closure of 20 beds, the elimination of 171 jobs, and consolidation of services at the new site. Featured speakers included Roy Brady (Peterborough Health Coalition), Natalie Mehra (Ontario Health Coalition) and Michael Hurley (OCHU). Marion Burton from OPSEU also spoke.
To view a short video of the meeting, see below:
Posted in Hospitals
Part of the Peterborough Regional Health Centre includes consolidating the rest of its operations at its new suburban facility. For the Women’s Health Centre, leaving the existing downtown location may make the facility less accessible to many clients. The Centre has taken many cuts — there has been a reduction of social work service for sexual abuse, for eating disorders, the resource librarian has been cut as has the “Well Women” programming. Staff cuts means there is also no capacity to nurture and strengthen community partnerships. The lactation (breast feeding) consultant has already been moved out to the main hospital site. Friends of the Centre say the move will make it particularly difficult for young women, young mothers, women without transportation and women with limited financial resources to access women’s health programming.
Posted in Hospitals
Despite its significant impact on the lives of seniors, Ontario’s new Retirement Homes Act took a little over 60 days from introduction to passage through the legislature June 2nd. In the rush, only one day of hearings was set aside to listen to citizens concerned about its impact. When OPSEU presented, the committee appeared distracted to the point of MPP Paul Miller having to assure our presenters that the politicians were, in fact, listening.
Despite a last ditch effort to encourage MPPs to vote down the bill and take the time to get it right, both the Tories and Liberals voted to pass it this week, with only the NDP casting votes against it.
Bill 21 is about saving the government money. Unlike long term care homes, the care in retirement homes is not paid for as part of our Medicare system. The only exception to this is for alternate level of care patients transferred from hospitals. These patients are still effectively covered under the more extensive rules governing nursing homes.
Retirement homes were intended to be rental accommodations for seniors who are able to manage and pay for their own care. They are mostly designed for seniors who need minimal to moderate support with their daily living activities.
More and more our OPSEU members in these homes are telling us that the level of acuity of these residents is on the rise, requiring much more intensive levels of support they simply cannot provide. Increasingly, those who cannot find a bed in a nursing home are winding up in these facilities.
Instead of drawing a line in the sand, the new Retirement Homes Act essentially opens the door to retirement homes becoming a second tier of nursing home care. If you are rich, you can pay for enhanced services and find a bed right away. If you are of more limited means, the financial burden may be crushing and the level of care can be completely inappropriate.
We reported here yesterday that the North Simcoe Muskoka Local Health Integration Network has said there are no plans for new nursing home beds in that region despite a 98.8 per cent occupancy rate.
Why is that? If seniors are kept on long waiting lists for nursing home beds, cannot get access to adequate home care, and are pressured to leave a hospital anxious about the number of “alternate level of care patients” (ALC) occupying scarce beds, families are more likely to pay for that second tier of accommodation in a retirement home if they have the means. The average total monthly cost is $2,750 for a standard retirement space and $3,440 for a heavy care space.
What they get will be a crap shoot. With the new legislation, retirement homes do not face the same level scrutiny nor have the same level of regulation as a government-funded long term care home.
According to the Ontario Health Quality Council, wait times for long term care have tripled since 2005. The average wait is 105 days. Those waiting for placement from home are averaging a wait of 173 days – or about six months.
The new oversight body created under Bill 21 will not be much help. The Retirement Homes Regulatory Authority is not a government agency, but a third-party primarily made up of major stakeholders in the retirement home industry. Given it will be self-appointing, there is little doubt the group will represent the interests of providers, not consumers.
The new legislation may actually backfire on the province. With more than half of the present long term care nursing home beds being provided by for-profit corporations, there will be much incentive to turn these homes into lightly-regulated retirement facilities.
Posted in Long Term Care
Long term care wait times topped concerns by the Ontario Health Quality Council in its annual report released yesterday.
The OHQC says average wait time for a long term care bed is now 105 days. If you are waiting while at home, its 173 days (or about six months). Wait times for long term care placement has tripled since the spring of 2005. The council does suggest that one in four people presently in a long term care have light care needs and could be cared for in an alternate setting if one were available.
Despite Ontario spending $60 million last year on its ER wait times strategy, one in four patients still spend more time in the emergency department than the recommended target. About 6 per cent of patients leave the emergency department before being seen.
Ontarians are making no progress on finding family doctors. About 730,000 Ontarians are still without a doctor, about half are actively looking. Only 53 per cent of Ontarians can see their doctor on the same day or next day when sick – nine out of 10 surveyed say they think waits are too long for an appointment. There has been no change in the percentage of Ontarians without a family doctor over the last three years.
Doctors are also picking up the pace of converting their patient records into electronic files. In 2007 only 26 per cent of doctors maintained electronic records. In 2009 it was 43 per cent – still not quite half.
The report is also critical of the government’s ability to alter the social determinants of health. “Progress has been stalled for the past three years addressing unhealthy behaviours that could lead to chronic diseases. (Coincidentally, the NDP’s France Gelinas introduced a private members bill yesterday calling for fast food restaurants to post the calorie count of items on their menu boards.)
Other key wait time initiatives have had mixed results. Wait times have decreased for cataract surgery as well as hip and knee replacements. About 95 per cent of elective cardiovascular procedures are done on time. The Council does say that wait times are still too high for CT, MRI and urgent surgeries. They offer the example of urgent cancer cases, of which only 53 per cent are completed within the two week target.
While some progress is being made on diabetes, the report says there is huge room for improvement as many people are not getting the right monitoring.
Despite four years of the Local Health Integration Networks, whose mandate it is to integrate the health system, the report found Ontario does a poor job of sharing information across the system. Physicians are reporting delays in getting information from hospitals and specialists, while only one quarter of patients who leave hospital feel they have all the information they need.
Posted in Health System
Health economist Robert G. Evans has an alternate take on the question of health care sustainability. As bankers continue to claim health care costs will gobble up government budgets, Evans replied this week in the Toronto Star that health care is as sustainable as we want it to be. Evans says public Medicare expenditures have been relatively stable. However, private insurance, primarily for drugs and dentistry, now accounts for 12.7 per cent of Canadian health care spending – 14th highest in the world. Evans says health care has taken an increasing share of provincial spending as a “simple consequence of large cuts in non-health programs, not out-of-control medicare spending.” The economist points out that between 1997 and 2004 tax cuts removed about $170.8 billion from public sector revenues. Total provincial revenues are now about $35 billion per year less as a result, or about half the current provincial spending on Medicare. … After telling OPSEU their plans were firm to cut all seven full-time RPNs at St. Francis Memorial Hospital, the Barry’s Bay health care facility changed its mind after the story found its way into the local media. Four of the seven full-time jobs have now been saved. The remaining three have already taken voluntary exit package. … Police have laid fraud charges against the administrator of an Ottawa-area long term care facility. Joanne Talbot-Brisson appeared in court May 28 on 25 charges, including criminal breach of trust, fraud over $5,000, theft over $5,000, possession of the proceeds of crime, misappropriation of money held under direction, falsifying employment records and uttering a forged document. Two other women were also charged. It is unclear whether the newly passed Retirement Home Act would have made any difference. Jane Meadus, a lawyer with the Advocacy Centre for the Elderly (ACE), told the Ottawa Citizen that privately run care homes are “a bit of the wild west. They’re called different things in different places. There really doesn’t seem to be oversight.” . … Despite an occupancy rate of 98.8 per cent, the North Simcoe Muskoka LHIN says there are no plans to open up any more long term care beds in that region. Like other hospitals, Soldier’s Memorial Hospital in Orillia is shedding beds. The hospital plans to cut 25 beds over the next two years. Community members are concerned that with nursing home beds full, alternate level of care patients will have nowhere to go. Ontario has 56 per cent fewer hospital beds per capita than it did in 1990.
Posted in Health System
The Peterborough Regional Health Centre promised its own version of fiscal restraint after this spring’s peer review left the community reeling over the prospect of 71 bed cuts and the loss of more than 150 full-time equivalent (FTE) jobs.
Described as a working draft, the hospital released the new plan this week, limiting bed closures to 20 but looking for additional savings in such clinical areas pharmacy, rehabilitation, mental health, emergency room, sub-acute care, diagnostic imaging, laboratory, women and children’s, and other clinical support.
The new plan calls for fewer cuts to clinical areas such as critical care and medicine. The plan also calls for the equivalent of 20 fewer non-union and management full-time jobs. That would bring job loss to 170 FTE jobs. While it claims it is throwing these managers and non-union staff on the fire, the hospital indicates these jobs have already been eliminated. It is one of the few areas in the hospital’s presentation that they appear to regret, stating the change “may negatively impact managers (sic) ability to be effective.”
The hospital says that the plan is based on 2,400 cost saving ideas generated from front line staff and physicians. The fact that some of these initiatives are underway, or complete, suggests this may not be entirely a “working draft” as indicated in PRHC’s press release. Eight of 26 strategies are listed as either underway or complete.
Telemetry is still left unresolved, although the original peer review called for $800,000 in savings despite the Central East Local Health Integration Network plan to designate Peterborough as a cardiac care centre. Telemetry devices are used for patients who are at risk of abnormal heart activity.
While many hospitals are increasing housekeeping staff as a way to reduce hospital-borne infections, the revised plan reduces housekeeping staff at PRHC by 11.3 FTE jobs. Despite saving 50 beds, the hospital’s plan makes few adjustments to the peer review’s recommendation to cut 131 FTE positions delivering clinical services. Under the hospital’s plan, 124.6 FTE jobs will still be lost in clinical services, leaving many to question who is going to be staffing those 50 saved beds.
With so many fewer staff, the impact on workload may challenge the hospital’s plan to reduce absenteeism costs by $1.4 million, overtime by $1 million, and health and safety by another $500,000. (See Linda Duxbury’s study on Role Overload: https://opseudiablogue.wordpress.com/2010/02/02/health-care-workers-face-anxiety-fatigue-burnout-as-a-result-of-“role-overload”-study/)
The hospital plan includes raising parking rates, which it has already completed. The report admits this will impact public satisfaction, which they intend to overcome by explaining the need to do so.
The hospital picks up on the peer review’s insistence of reducing length of stay, including reducing the number of days palliative care patients can be cared for in hospital. It is unclear how the hospital will deal with palliative care patients who refuse to die within timeframes established as Ontario benchmarks.
While the hospital is now engaging the public, physicians will be specifically engaged over reductions in their remuneration. Nearly one in five local physicians are expected to retire by 2016. Without the means to attract new physicians, Peterborough could struggle to find replacements.
Reducing clinical staff could backfire in the near future given the region is expecting substantial numbers of health professionals to retire within the next five years. In a report from Employment Ontario, it is estimated about one in five regional health professionals would retire from 2006 to 2016. That includes 19.1 per cent of general practitioners and family physicians, 38.1 per cent of medical laboratory technologists and pathologists’ assistants, 29.1 per cent of registered practical nurses and 22.8 per cent of registered nurses.
While these retirements may allow for a greater opportunity to reduce overall staffing levels, it will leave remaining staff with heavier workloads and patients less access to the care they deliver.
After the peer review castigated the board for assuming funding would some day come, the new plan does assume $2.6 million would arrive in the form of a funding increase for 2010/11. This may be realistic given the provincial budget did state it was passing on a 1.5 per cent increase in core funding for this year.
Neither the peer review nor the hospital’s plan will make it possible for Peterborough to balance its budget in this fiscal year, although the hospital says a balanced budget will happen March 31, 2012.
In March the Central East LHIN approved an extension to the hospital’s accountability agreement under the assumption that $26 million in “efficiencies” would be found this year. However, for Peterborough to default on its accountability agreement with the LHIN is hardly news anymore.
The total budget is estimated to be $246 million by 2012. While 170 FTEs are being eliminated, the hospital clearly plans to hire some back, given it is estimating 141 fewer staff by 2012. The PRHC presently has 2,141 staff.
Given the Orwellian name of “Hospital Improvement Plan,” (HIP) the new restraint plan is expected to go to the PRHC board June 28th and to the CE LHIN for final approval July 20.
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The Peterborough Health Coalition is hosting its own forum on the new hospital plan:
Public Meeting – Health Care Cuts at the Peterborough Regional Hospital
Thursday, June 3rd / 7 pm
Evinrude Centre – 911 Monaghan Rd., Peterborough
For more information, call 742-4826 / 745-2446 / 742-5326
Posted in Hospitals
NORTH BAY – The local committee established to investigate the details surrounding a decision to move 31 specialized care patients from North Bay to Sudbury has some very serious concerns following a review of the report prepared by Medical Experts at the North East Mental Health Centre (NEMHC) and new information raised at a meeting held with the CEO of NEMHC/Regional Advisory Panel (RAP) Co-Chair.
In the report the medical staff clearly state that the proposed Sudbury location for the transferred beds — The Kirkwood Site — is not a suitable facility. They indicate that a new facility will need to be built in Sudbury to accommodate the specialized care patients. Additional financial resources will be needed to retain existing medical staff and to attract and train new staff for the facility in Sudbury.
“It seems preposterous that a decision of this magnitude could be made without even considering the costs involved with the decision. From what we can tell, this move is going to cost the taxpayers millions of dollars for absolutely no reason” stated Sean Lawlor, President of the North Bay Chamber of Commerce. “If the RAP would have consulted with the experts prior to making their recommendation, they would have been aware of the significant challenges associated with moving these patients to Sudbury.”
“Our contention is that the best interests of patients would have been better served by looking at the total costs of this decision. If money can be saved by keeping these patients here in North Bay, while maintaining the same levels of high quality service that they have been receiving for years, the savings can be used to provide the specialized care services that these patients need and deserve” says OPSEU Local 636 President, Jackie Smythe.
This concern was further compounded during a meeting between the committee and the Northeast Mental Health Centre CEO and Co-Chair of the Regional Advisory Panel, when it was learned that the RAP’s scope of work was actually quite narrow. Rather than comparing any legitimate options that either community might have had, the RAP only considered the merits of locating these patients in one community over another. This confirmed the belief of the committee that neither the Cassellholme option, nor any real option, was ever presented or considered by the panel.
“How can a decision of this magnitude be made without even knowing what specific options exist in either community? Cassellholme had a local solution that would have addressed many of the issues identified by the Medical Experts at the NEMHC, but our solution was totally ignored by the RAP throughout the process. It appears as though the RAP ignored just about every aspect of what would have been required to make an informed, logical decision. How is that in the best interests of patients?” stated Dave Mendicino, Chair of Cassellholme.
Finally, the committee was equally confused to learn that the directive to move these patients from North Bay to Sudbury actually came about two years ago, when the Ministry of Health and Long Term Care (MOHLTC) notified the NEMHC that these patients would be moved to Sudbury. This contradicts what the committee had been told all along, that the decision was at the discretion of the North East Local Health Integration Network (NE LHIN).
“Clearly, the LHINs are not arm’s length from the Province. Our concerns regarding the MOHLTC making the presentation to the RAP supporting the Sudbury option makes perfect sense now, since this whole process appears to have had a pre-determined outcome from the beginning. Unfortunately, this process has cost taxpayers a lot of money that could have been better spent on providing health care services to the people that need it,” says committee member Derek Shogren.
“The interests of these patients needs to be front and centre, and from the information we have available to us now, it appears as though the best interests of the patients were trumped by some other motivation” says Lawlor. “At this point, we are calling on the MOHLTC to reverse this decision and address the variety of concerns that were identified by the medical staff by keeping these patients here in North Bay.”
Based on the information that has surfaced over the last several weeks, the committee expects that Health Minister Deborah Matthews and local MPP Monique Smith will be supportive of keeping the beds in North Bay.
Posted in Mental Health
OPSEU Diablogue 