July 8 the Ontario Health Coalition brought more than 80,000 signed cards to the Ontario legislature opposing the transfer of clinical services from hospitals to private clinics. (Photo courtesy the Ontario Health Coalition)
The media is applauding Health Minister Dr. Eric Hoskins this week for promising greater transparency around private clinic inspections that had previously been kept secret by Toronto Public Health and The College of Physicians and Surgeons of Ontario (TCPSO).
Tom Closson, the former President and CEO of the Ontario Hospital Association, suggested in the Toronto Star last week that “bringing out-of-hospital clinics up to the same standard as hospitals regarding transparency would increase public confidence in the care they are seeking.”
Ontario’s Action Plan for health care includes systematically taking clinical services out of public hospitals and transferring them to a sector that has a history of two-tier medicine, questionable user fees, unnecessary up-selling, significant quality control issues and too little transparency. The latest revelations, particularly around infection control at several private clinics in Toronto, may have persuaded the government not to carry out spring and summer competitions for selected hospital clinical services – at least for now.
They may have learned from the Ottawa Hospital’s ill-timed decision early in 2013 to divest 5,000 endoscopies to the private sector at the same time the TCPSO was making public the list of clinics that failed inspection public – including one Ottawa endoscopy clinic that may have exposed patients to HIV, hepatitis B and hepatitis C from equipment that may not have been properly sterilized.
This spring the Ontario Health Coalition collected more than 80,000 postcards expressing opposition to the transfer of services from public hospitals to private clinics. Without any clear indication from government whether the competitions are on hold, the coalition is now working towards a November 21st mass rally in Toronto to push further on the issue.
It makes us wonder why so few hospital CEOs are willing to publicly go to bat for their institutions. It’s true that in the past public advocacy was not always met with great appreciation at Queen’s Park, which has the power to take over a hospital and deal with sticky problems in their own way. Joe De Mora’s time at the Kingston General Hospital certainly comes to mind.
With hospitals having experienced their first year of a base funding freeze, and with perhaps a second lurking in tomorrow’s provincial budget, CEOs are going to be under a lot of pressure by communities reluctant to give up health services – especially in tough economic times. With costs rising and increased demand on their doorstep, a freeze represents a significant real cut to hospitals. High profile job losses at Ontario hospitals are already part of the landscape. The question is, what will year two of this look like and who will stick their head out to say something?
While some CEOs are parroting the Queen’s Park line about restructuring, others are starting to get some traction on their issues.
We don’t quite know what to make of this one.
Our most quotable of hospital CEOs is now saying that the erotic bestseller 50 Shades of Grey may be responsible for a mini baby boom in Windsor, Ontario.
Windsor Regional Hospital CEO David Musyj has been all over the media recently after speculating a 30 per cent jump in births over a six-day period may have something to do with the publishing nine months earlier of E. L. James’ steamy novel.
“If you back up the calendar, the book of 50 Shades of Grey was released worldwide and in Canada earlier this year,” he told the media. “There is talk around the hospital that it is possible that the release of that book has something to do with the increase in births.”
Our national broadcaster – the CBC — took this story very seriously, consulting a sexuality professor and a demographer. The professor suggests Musyj could be right while the demographer is more cautious given there is an overall “echo effect” – the children of boomers are now having kids of their own.
Of course, the question is, why only in Windsor? Are women there just particularly fast readers and subsequently ahead of the trend? Is 50 Shades of Grey doing for the Windsor library’s circulation what the book is doing for that of its readers?
Musyj also suggests that blackouts and big collective agreements may also spur mini-baby booms at his hospital.
You might say the results are a secondary labour movement.
When faced with underfunding, should hospital CEOs make clear the consequences, or should they quietly find ways to cut services that may be less noticeable to the public?
For the first time since the Harris government, the McGuinty government has frozen base funding for hospitals. In addition it has introduced a new funding formula that is having negative repercussions for some.
We have always argued that having a funding formula makes sense, but such a formula should be grandfathered in so that hospitals on the losing end of the equation are not adversely affected. There are also questions about whether the formula itself is fair, some arguing that existing patterns of use are partly determined by where existing services are, as opposed to where services should be.
The net result of these changes in funding is hospitals are faced with particularly difficult choices this year.
Many choose to quietly go about their chopping, limiting input to board and management. Others talk publicly about consequences leaving the broader community an opening to debate what should take place.
The latest to talk about consequences is David Musyj, CEO of the Windsor Regional Hospital. Last week Musyj warned of possible layoffs and cuts to services, such as endoscopy and ultrasound – both he says are offered at private clinics in his community.
CCACs hire 144 direct care nurses
This month the government announced 900 new nursing positions to come from their 2007 commitment to 9,000 new nurses for the health system. Among them are 144 nurses who will go into the schools to support early identification and intervention of students with potential mental health and/or addictions issues. The nurses will assess and develop plans of care, provide direct service for mild cases, and offer support and referral for more complex issues. What’s particularly interesting about this initiative is these nurses will be working directly for the Community Care Access Centres, the first new hires to provide direct care since Bob Rae was in the Premier’s seat. When Mike Harris changed the NDP’s multi-service agencies into the CCACs, he insisted that a strict purchaser-provider split exist, hoping to divest all direct care workers to private agencies. He never entirely succeeded – OPSEU still represents CCAC home care therapists that were supposed to be divested by 1998. The fact that the government has placed these nurses into the employ of the CCAC is a hopeful sign that the terrible Harris-era competitive bidding process may quietly be coming to an end. While Deb Matthews publicly said competitive bidding would return, OPSEU members are telling us the agency contracts are all being extended again.
Merging surgical departments in Windsor
A zero base budget for hospitals is forcing many administrators to look at novel ways to make ends meet. In Windsor much has been made about Finance Minister Dwight Duncan’s proposal for a very expensive mega-hospital, however, the two hospitals are looking at integration options that might save money in the meantime. Windsor Hotel Dieu is pushing for greater coordination of surgical departments with the Windsor Regional Hospital. Facing a $700,000 operating room budget deficit, Dieu is hoping costs could be saved by having the two hospitals move into even greater specialization than currently exists. Dieu presently specializes in trauma and neurosurgery while WRH does most of the pediatric surgeries. WRH CEO David Musyj told the Windsor Star he was cautious — concerned that Hotel Dieu’s financial problems could put more pressure on his 11 operating rooms.
Harper attacks Council of Canadians
Our friends at the Council of Canadians are under attack by the Harper government for encouraging Canadians to overturn elections of seven Tories elected in ridings involved in the so-called robocall scandal. According to the Ottawa Citizen, the Federal Tories hope to overturn lawsuits that seek new elections in the ridings. The Tories are basing their bid to throw out the lawsuits on an obscure and ancient legal prohibition against “champerty and maintenance,” which the Citizen describes as “meddling in another party’s lawsuit to share in the proceeds.” While the Council of Canadians would not stand to gain anything monetarily from the actions, the Tories highlight a Council fundraising campaign that notes the challenge among its work. Of course the Tories have no problems with right-wing organizations, many with American funding, helping to litigate against such left-wing institutions as Medicare. That includes the Canadian Constitution Foundation, an extreme right-wing group based in Alberta that supported Lindsay McCreith and Shona Holmes in their 2007 case intended to open up Ontario to two-tier private health insurance. While the CCF doesn’t say where their money comes from, they do specifically note on their website that they have charitable status with the U.S. Internal Revenue Service. Like the Council of Canadians, the CCF lists its McCreith/Holmes case as among the worthy activities it undertakes to solicit donations.
Posted in CCAC, Home Care
Tagged 900 new nursing positions, Council of Canadians, David Musyj, Deb Matthews, Dwight Duncan, Lindsay McCreith, right wing advocacy groups, Shona Holmes, Windsor hospital merger, Windsor Hotel Dieu, Windsor Regional Hospital
While cancelling the new $136.8 million West Lincoln Memorial Hospital in Grimsby, along with cuts to five other hospital projects across the province, Finance Minister Dwight Duncan announced a task force to look at building a new $1.5 billion regional hospital in his Windsor constituency.
The new super hospital would replace both Windsor Regional Hospital and Windsor Hotel Dieu. This is even though both hospitals have undergone recent additions, including a $91.6 million mental health facility at WRH and an $80 million cardiac care expansion at Hotel Dieu. Last year the government also approved a $60 million expansion of WRH’s ER and laboratory facilities – a project that wasn’t shelved as part of the McGuinty austerity budget.
Despite more than $230 million in new builds at the two hospitals – almost twice what it would cost to rebuild West Lincoln, Duncan estimates the Windsor hospitals will require another $1.8 billion in new capital projects to keep the two hospitals operating.
David Musyj, CEO of Windsor Regional, says both the buildings and the site are physically inadequate for what’s needed in the near future.
Our friend David Musyj is mellowing.
The CEO of Windsor Regional Hospital, once a vocal advocate for wage freezes, now says either freeze all wages or none at all.
Musyj told the Windsor Star that it’s a morale breaker when the government freezes wages for just one group.
He says the impact of extending the freeze will be negative because further penalizing this group for “political gain” is grossly unfair.
We agree. As public sector workers, it is a morale breaker to see calls for more austerity when our wage increases are already well below the private sector.
If you regularly read these pages, you’ll notice that we have been sounding the alarm for some time now about the surge capacity of hospitals.
If you have an average occupancy of 98 per cent, what happens when you have a bad flu season or there is a significant pandemic in the community? You can’t, as Spinal Tap’s Nigel Tufnel recommends, turn it up to 11.
One of our favourite targets here at the Diablogue is Windsor Regional Hospital CEO David Musyj, who has a habit of blaming everyone but himself for his hospital’s ongoing woes.
Musyj is back in the media this week telling Windsor residents to think about going elsewhere after the holidays given his already clogged emergency room at the Metropolitan Campus is going to get worse.
The fact that the ER is clogged during a traditionally quieter time is “making us very concerned about what we’re going to see after the holidays,” Musyj told the Windsor Star.
Less you worry about your ability to get treated after that somewhat uncooked turkey, Musyj also says “there is nothing dramatic changing one way or another.” Huh?
Musyj says he will have extra beds to fill with those emergency patients, but doesn’t say where they are coming from.
Maybe it’s a slow news day in Windsor. Then again, it could be yet another early warning that cutting all those hospital beds over the last decade may have gone a little too far.
Windsor Regional Hospital CEO David Musyj is suggesting the best way to bend the health care cost curve is to amalgamate his hospital with Windsor Hotel Dieu Hospital.
As usual, Musyj lacks any evidence to support his suggestion, made before an audience of Rotarians in that city.
He may instead want to look at the independent Canadian Health Services Research Foundation web site, which says there is no evidence that such mergers save money.
“While the intuitive appeal of ‘bigger is better’ in hospital mergers is powerful, it’s clear the empirical evidence is weak and the potential for negative outcomes significant,” the Research Foundation states.
The Foundation warns that mergers are particularly difficult on staff morale, which has a direct impact on the quality of patient care.
They also note that mergers can disrupt services and absorb more management attention during a transition period, also affecting patient care.
The Windsor Star notes that the merger may be a tough sell given the last such merger cost the region two hospital sites and beds.
When mergers do occur, senior management usually go cap in hand to their boards, asking for more compensation to deal with the greater responsibility they now face.
Other money saving ideas Musyj gave the Rotarians include cuts to outpatient services and charging patients a fee for emergency room visits – the latter a clear violation of the Canada Health Act.
Musyj said Ontario needed a Royal Commission to look at the way the province delivers health services.
He also defended the LHINs, suggesting moving administrative offices to London or Toronto would not be in the best interests of his community.