“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.
For more than 30 minutes a resident of The Wexford went on a rampage, roaming the halls of the Scarborough long-term care facility, battering one woman before leaving his own floor and heading upstairs to kill another.
It wasn’t the first time that this resident had been involved in a violent assault at the home. A psychiatrist had assessed the resident as a chronic risk to others and recommended he be placed in a psychiatric group home better suited to manage his behaviour.
Despite a scathing Ministry report on the incident, the last time The Wexford had undergone a detailed inspection by the Ministry of Health was 2009.
Last year Health Minister Deb Matthews had said homes that generated few complaints or critical incidents would not likely undergo such an inspection, since the new resident quality inspection (RQI) regime would only apply to those homes that raised the most red flags.
Oh come on now. Attending question period at Queen’s Park can be an exercise in frustration as the opposition’s questions and the government’s answers seldom align.
You can ask anything you want, but it doesn’t necessarily mean the government will provide you with an answer that remotely addresses it.
Yesterday NDP Leader Andrea Horwath asked the Premier about an 80-year old patient at the London Health Sciences Centre who says he was told to clean his toilet.
Joseph Cummins was not just any patient – he is a retired professor of genetics at Western University and knows about hospital-acquired infections.
According to today’s Toronto Star, Cummins wandered out into the ward looking for someone to clean the bathroom he shares, at first finding no professional staff on the ward. Cummins admits to having had a mishap after being given a strong laxative and wanted to ensure it was cleaned up.
The closure of eight downtown Toronto hospice beds is hardly creating buzz in the health care community. But it should.
Perram House hospice is not big enough to warrant major headlines, but it is symbolic of why the government’s policies around service transfers to community-based providers are so flawed.
Perram House gave its workers two days’ notice that the hospice will close on Wednesday. Up until this point, there was no indication that the operators were even considering closure. If you visit the Perram House website, as of this afternoon it still is promoting its services. There’s still a button to become a “friend” of Perram House. There’s still an endorsement from actor Eugene Levy, even if the internet link to the video doesn’t work anymore.
We don’t know when the Toronto Central LHIN found out about it, but they reported to us that three of the patients have been transferred to the Grace Hospital and two more are now at home in the hands of the Community Care Access Centre. They figure their job is done.
Eight hospice beds are now gone from the mix. This is not how health system planning is supposed to take place. There was no public consultation. There is no assessment of need. It is closing because the Perram House board has decided to do so.
Perram House’s board has offered no explanation for the sudden closure.
Here we go again. This week news of another shocking nursing home death – this time in The Wexford, a Scarborough long term care residence. A second resident was also injured in the resident-on-resident attack.
Health Minister Deb Matthews predictably told the Toronto Star “if there is anything that can be learned from this incident, you have my commitment that action will be taken.”
In 2003 then Health Minister George Smitherman was moved to tears after a Toronto Star series on resident abuse. His famously vowed a “revolution” in long-term care.
In 2005 a Coroner’s jury made 85 recommendations after investigating the 2001 deaths of two residents at the hands of another in a different Toronto-area nursing home.
At the time the report was released, the home’s lawyer suggested there was a gap in the system for specialized long-term care units for residents with cognitive impairment (today that describes almost a third of all long-term care residents).
Smitherman declined comment that time.
In 2008 David Caplan was asked about a Canadian Press series that showed three-quarters of Ontario long-term care homes were not in compliance with provincial legislation. Caplan said he was too new to the post to comment and promised nothing.
In 2010 Metroland, which operates community newspapers across Ontario, ran its own series on long-term care. They called it “Situation Critical.”
Dr. Jack Kitts, CEO of the Ottawa Hospital, says he plans to transfer about 5,000 endoscopies to community hospitals and clinics as part of an overall plan to find $31 million in savings towards balancing the hospital’s budget.
Kitts announced last week that 290 full-time equivalent positions would be eliminated at the hospital, including 90 positions in nursing, 100 in administration and support services, and a further 100 “other” health professionals. There is no word whether any senior managers will have to fall on their sword.
The impetus for the cuts are clear – The Ottawa Hospital is facing the long-term prospect of zero per cent annual change in the base funding while costs continue to rise with a growing and aging population. It has little to do with restructuring.
Divesting 5,000 endoscopies may save the Ottawa Hospital money, but it won’t necessarily save the provincial health budget as these costs get borne elsewhere. Then there’s the matter of The Ottawa Hospital facing direct costs related to severing employees. Kitts says it’s cheaper to do these endoscopies elsewhere, but he gives no evidence to back up his claims.
Calculating the human cost of such actions is always much more difficult. The Ottawa Hospital was subject to a major study in 2009 on role overload, suggesting workers at the hospital were already facing anxiety, fatigue, and burnout as a result of having to do too much with too little. For those left behind, the fear of having their workload become totally unmanageable is very real, raising questions about how safe the hospital will really be.
Pop quiz: who wrote this: “Our government expects – as do health care providers – that this change will exacerbate the health conditions of patients with chronic conditions and those who are at risk of developing such conditions. In addition, given preventative care is less costly that emergency or acute care treatment, your policy represents a significant download to provinces and especially Ontario, where the vast majority of refugee claimants reside.” If you guessed Ontario Health Minister Deb Matthews, you’d be correct. Matthews’ wrote Federal Citizenship and Immigration Minister Jason Kenney in December over the impact of cuts to the Interim Federal Health Program for refugees. Tomorrow (Wednesday) opponents of the federal cuts will be meeting outside of Deb Matthews’ downtown Toronto office to ask Ontario to have a heart and provide stop-gap coverage for these disenfranchised refugees left without coverage. Demo starts at 11:30 am near Bay and Wellesley Streets in Toronto.
Windsor Regional Hospital is closing its long-standing Acute Injuries Rehabilitation and Evaluation Centre after the facility lost $300,000 last year. Once a revenue-generator for the hospital, the centre provides assessment and treatment services to people injured in automobile accidents or on the job. Revenues came from WSIB and other private insurance providers. The hospital claims two other private centres have meant that this insurance work done by the hospital has “dried up.” Curiously Windsor lawyer Suzanne Dajczak told the CBC that the closure would mean costs would shift to the patients. “When you’re injured, you’re under stress, finances generally are cut – in the cases that I see, substantially. They usually come when they’re denied and, yes, they’re going to struggle, and it’s going to be more difficult for injured workers” (Emphasis added). Is Ms. Dajczak suggesting that these private clinics may be less supportive of injured worker claims than the public hospital?
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Tagged Andrea Horwath, Cindy Forster, Deb Matthews, Interim Federal Health program, Jason Kenney, Jim Bradley, Kensington Eye Clinic, Kensington Screening Clinic, Kevin Smith, Liberal Leadership, Niagara Health System, Ontario Health Minister, Quinte Health Care, Sandra Pupatello, Suzanne Dajczak, Tim Hudak, Windsor Regional Hospital