When Health Minister Deb Matthews spoke at the closing of this year’s Ontario Hospital Association (OHA) HealthAchieve, the hall was two-thirds empty. Only two days before there was standing room only for Canadian astronaut Chris Hatfield.
Attendance at the final morning of the OHA’s annual get-together is usually smaller than the preceding two days, but we’ve never seen it this sparse.
Former Health Minister George Smitherman could usually command a decent audience on the final day. For Deb Matthews, the reception might be connected to how hospital executives are feeling about the restraint they are under.
Two years ago the OHA reminded the province that the Harris Tories had planned three years of cost cutting at Ontario hospitals but had to abandon the effort after year two.
Not only did the Tories halt the last $507 million in cuts in 1998, but had to substantially increase their restructuring budget.
The OHA maintains those were days when hospitals could better afford the haircut.
At this year’s Ontario Hospital Association HealthAchieve the organizers hired a graphic artist to illustrate many of the sessions. After each session, participants were invited to look at the graphic and leave their own comments behind using Post-it notes.
Amid all the talk of living in times of revolution and the need to recognize creativity throughout our organizations, one person put up a note that said: “we are afraid of loosing control.” We can only assume the individual was a bit spelling-challenged and meant “losing control.”
That was probably the most frank statement we saw over the three days.
Despite being challenged by some great international thinkers – including Sir Ken Robinson and Ray Kurzweil – this year’s conference seemed to be missing some of its usual mojo.
Ontario has been remarkably resistant to the idea of staffing standards in long-term care.
Staffing is a major determinant of quality in long-term care – something even the most casual observer should understand.
Such standards are not uncommon in other jurisdictions – many have based regulations on a comprehensive U.S. Department of Health and Human Services study that stated a daily minimum of 4.1 hours of total nursing time (including personal support workers) is required to avoid common quality of care problems such as bedsores, weight loss, and loss of bodily functions for long-term care residents. That was in 2002.
There is not general agreement on how nursing home staffing is measured in Ontario, making it difficult to directly compare existing data to this benchmark. However, experts suggest that Ontario is hovering somewhere below three hours of direct care per resident per day based on average acuity.
“This is a case where the wheels are literally falling off the bus.” – Andre Marin, Toronto Star, July 16, 2013
Back in June 2011 the Ontario government promised legislation “at the earliest opportunity” to regulate the private patient transfer industry.
The first real promise of that election campaign, Health Minister Deb Matthews was prompt in her reaction to a scathing report by the Ontario Ombudsman that suggested taking a taxi was far safer than climbing aboard one of the province’s privatized patient transfer vehicles.
We’ve all seen these vehicles. They look like ambulances. Some have emergency lights just like real ambulances. The drivers often dress like paramedics. But that doesn’t mean they are.
It is very unlikely that Deb Matthews personally wrote the letter sent to a member of the Quinte Labour Council about local hospital funding. She did sign it, which suggests she may have actually read it. Maybe.
The letter has been circulating recently, serving to raise more ire than balm.
There it was again – the claim that “without change of course, health spending would eat up 70 per cent of the provincial budget within 12 years.”
If you really want to scare people, try suggesting alien spaceships will land in Nathan Phillips Square disembarking a robot army that will change life forever. The two scenarios, the 70 per cent and the robot army are about equally likely. At least in the latter scenario we would be rid of Rob Ford.
Perhaps Matthews should tell her letter-writing minions to cool it on the rhetoric about how health care is about to consume huge portions of the provincial budget if not for their heroic efforts to reform the system. It’s getting old and most sensible people know by now that it is simply not true.
In some ways the injunction filed by the Designated Physiotherapy Clinics Association of Ontario may have been a blessing in disguise.
As of August 1st OHIP funding for these private clinics was to cease, their clients transferred to the Community Care Access Centres. Now that decision awaits the outcome of an application for judicial review this week — August 21.
Last year OHIP received $200 million in billings from these designated private clinics even though the government had only budgeted $146 million. Chantale LeClerc, CEO of the Champlain Local Health Integration Network, told the media that the province had already increased funding for physiotherapy by 70 per cent three years ago, and that expenditures were anticipated to double by 2014.
Now the government has determined the funding will be $156 million by placing the responsibility in the hands of organizations with fixed budgets and LHIN accountability agreements. The private clinics argue that represents a cut of $44 million.
When Ontario last drafted a strategic plan for the delivery of comprehensive mental health services, the Mental Health Commission of Canada didn’t even exist.
Today we are still implementing mental health recommendations from Ontario’s Health Restructuring Commission issued in 1998. Much of the basis for that report would have come from data generated in the mid to early 1990s. That’s about 20 years ago. None of the recommendations contained in last year’s national strategy would have been in play. Nor would the health restructuring commission have been faced with the more recent and alarming projections on the rise in dementia anticipated by the Alzheimer’s Society. Nor would they have known about the links between mental illness and rising levels of economic inequality, or that Canada under the Harper government would pursue such a reckless path to the point where levels of inequality are rising faster here than most other developed nations on the planet.
That’s a long time to pursue a single plan, especially without any evaluation in-between to see how implementation has been working.
There is likely reluctance on the part of the province to do such an evaluation because it is so self-evident that it is not working. Even the all-party legislative committee looking at mental health could see the huge challenges before us and had their own lengthy list of reforms – most of which never emerged off the pages of their final 2010 report.
When David Caplan briefly sat in the Health Minister’s chair, he did promise a new 10-year mental health plan for Ontario. We never got it. Instead Health Minister Deb Matthews’ concern never extended beyond a plan for children and youth that is now in its final year of implementation. Nobody knows what comes next. They are certainly not consulting the front line workers that have to pick up the pieces of failed policy initiatives.
Part of the problem of that original 1998 plan is that the government only followed half the advice. They stuck doggedly to the bed cuts at the province’s psychiatric hospitals, but were less interested in providing equivalent scale services in the community. Nor were they interested in ensuring the services first existed before making the bed cuts.