This winter we noted the constantly shifting terminology around cuts to clinical services at The Ottawa Hospital. At first the public was told by the Health Minister and Premier that cuts to thousands of endoscopies at The Ottawa Hospital were part of health care restructuring. We asked why it was therefore not being treated as an integration decision by the Champlain Local Health Integration Network? The LHIN replied that because the “cuts” (not restructuring) were actions taken as part of the hospital’s accountability agreement, no integration decision was required. For the public, no integration decision means no consultation and no transparency. Despite multiple protests around the cuts and profile given to the issue during the Ottawa South by-election (in which the Tories oddly said jobs were being cut at the hospital because of too much spending on health care) the Champlain LHIN refused to consider intervening. Given its lack of interest in a massive transfer of diagnostic services in the Ottawa area, it is remarkable to note what the LHIN is now deciding upon: parking. While the Ottawa hospital could cut clinical services at will, it sought the approval of the LHIN to build a new $12.5 million parking garage that will be paid for over four years by drivers shelling out $13 a day. Evidently parking is important to health planners. Endoscopies? Not so much.
Last week we noted that Hamilton Health Sciences was caught off guard by a Freedom of Information (FOI) request issued by the Hamilton Spectator. The newspaper had requested executive and board expenses going back to 2007 at the hospital. HHS initially told the newspaper that it would pass on costs of more than $17,000 to retrieve thousands of invoices from an off-site storage facility. The hospital also said it would take staff until the end of the year to sift through the invoices to fulfill the request. Upon appeal, the hospital has now agreed to supply the information by the end of September and fees have been reduced by the adjudicator to $1,228. The fact that a hospital with an annual budget of $1.2 billion could not access these records electronically was astonishing to us, although CEO Murray Martin told the newspaper that in the past year they have implemented a fully electronic financial software system. When Diablogue used the same FOI process last year to track staff-management changes at 20 Ontario hospitals, many claimed to have to resort to manual processes to fulfill our request. It cost us more than $1600 to get the answers demonstrating the freedom of information is far from free.
Kudos to Camille Quenneville, CEO of the Canadian Mental Health Association, for pointing out governments looking to contain costs and provide better service should address mental health issues within their own workforce. Writing in the Ottawa Citizen last week, Quenneville points out that every day 500,000 Canadians are absent from the workplace because of mental health problems. Someone suffering a mental illness will be absent from work on average twice as long as someone with any other disability. Mental health illness account for about 30 per cent of short and long-term disability claims. Clearly this is not just an issue with government, but with all employers. The CMHA CEO does acknowledge that many municipalities are already beginning to address the issue through wellness programs and education programs that particularly address stigma. Earlier this summer Partners for Mental Health launched their own workplace program “Not Myself Today.”
The Canadian Medical Association Journal reported over the summer on what could be a groundbreaking piece of research being conducted by Dr. Evelyn Forget at the University of Manitoba. From 1974 to 1978 Dauphin Manitoba took part in a unique “labour market experiment” in which locals were given a guaranteed annual income supplement to keep them out of poverty. The CMAJ says the experiment folded as a result of high interest rates and declining political interest in the concept. However for the last three years Dr. Forget has been wading through 2,000 boxes of data from the experiment. The data she is uncovering provides strong evidence that lifting people out of poverty has a remarkable effect on population health, especially with regards to mental health. Surprisingly, taking people out of poverty also reduced accidents and injuries. She also found that families kept their kids in school longer under the guaranteed income program. Given the revival of political interest in the social determinants of health, Dr. Forget’s ongoing research around a 35-year old experiment may pay some social dividends.
Posted in Uncategorized
Tagged Alex Hukowich, Austerity, Camille Quenneville, Canadian Mental Health Association, CMHA, corner stores beer and wine sales, Daughin Manitoba experiment, Dr. Evelyn Forget, Hamilton Health Sciences, HHS executive expenses, Long term care inspectors, Nick Fillmore
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.
We sometimes get asked about how we come up with stories for the Diablogue? For us, it’s not a matter of finding stories, but prioritizing material culled from a fast-moving stream.
Last week we focussed on the outrageous decision by Canadian Blood Services to increase imports of American-sourced plasma products while closing the last dedicated Canadian plasma donor clinic in Thunder Bay.
However, there are many issues out there, and only limited BLOG time for us. Here’s just a taste of some of the stories we missed last week:
Part of the fallout from the provincial budget is the decision to postpone a number of capital projects, including new hospitals. Nowhere is this being more felt that in Grimsby, where the community is upset that the new $138.8 million rebuild of the West Lincoln Memorial Hospital has been put on the shelf. The “Rallying for WLMH Committee” has called for a “massive rally” May 2nd. When the hospital faced closure in 1997, more than 7,000 people came out in a similar planned rally.
A new CIHI (Canadian Institute for Health Information) report raised eyebrows when Lakeridge Health and the University Health Network came out at the bottom of list of GTA hospitals. Lakeridge (with sites in Oshawa, Port Perry, Bowmanville and Whitby) pointed out that according to CIHI data, they were doing better than the provincial average on six of seven clinical performance indicators. That includes 80 per cent better than the provincial average when it comes to readmission after hip replacement surgery, and 30 per cent better on knee replacement surgery. An on-line tool that CIHI developed to rate hospitals crashed after it was swamped with users following a front page story in the Toronto Star.
Now that hospitals are subject to Freedom of Information requests, how accessible will this information really be? It all depends on the hospital and how much money you have.
It cost us $1,637.76 to find out what the ratio of staff to management was at 20 hospital corporations. That includes the $5 processing fee it takes to initiate the request.
Hospitals came under the Freedom of Information and Protection of Privacy Act on January 1st of this year, although the Ontario Hospital Association sought and received additional exemption from divulging quality information under specific circumstances.
For years we have heard front line staff complain that their numbers have dwindled while the ranks of management have increased. We decided to test that question with requests to 20 randomly selected hospitals where OPSEU represents members. This includes four mental health centres – Penetanguishene’s Waypoint Centre, Whitby’s Ontario Shores, London’s St. Joseph’s Health Centre (Regional Mental Health), and the Royal Ottawa Health Care Group.
Posted in Health System, Hospitals
Tagged Bluewater Health, Chatham-Kent Health Alliance, FIPPA, Freedom of Information, Grey Bruce Health Services, Hamilton Health Sciences, Hawkesbury and District Hospital, Health Sciences North, Hospital Freedom of Information, Kingston General Hospital, Niagara Health System, Ontario Shores, Peterborough Regional Health Centre, Quinte Health, Rouge Valley Health System, Royal Ottawa Health Group, South Bruce Grey Health Centre, The Ottawa Hospital, Thunder Bay Regional Health Sciences, Waypoint Centre, Windsor Regional Hospital, York Central Hospital