In 2013 Kingston residents voted overwhelmingly against a proposed P3 hospital in their city. Despite the results, the Province signed a contract to use expensive private financing to build a new facility to replace Providence Care Mental Health.
Infrastructure Ontario CEO Bert Clark says the $8 billion premium the government spent to build public infrastructure under the public-private partnership model doesn’t tell the whole story.
He’s right, but likely not in the way he’s suggesting.
Remarkably Tuesday night Clark clung to the $14 billion in savings Infrastructure Ontario says is made possible through the privatized model of infrastructure development even though the Auditor General made it clear that figure is based on flawed comparisons and a lack of empirical data to support it. In today’s Toronto Star he downgraded it to $6 billion.
Infrastructure Ontario was not so brazen in its initial response to Auditor General Bonnie Lysyk’s recommendations. Most of their responses in the AG’s report make minor admissions and rely on “third party experts” to justify the rest.
As we stated Tuesday afternoon, just two errors in cost allocation identified by the AG is enough to suddenly swing 18 privatized projects into the public column, saving the public treasury $350 million. Did their “third party experts” notice these errors?
In yesterday’s Star Clark highlights the Union Station renovation and the subway extension to York University as counter examples of public procurement projects that have experienced cost overruns and delays.
By contrast Lysyk points out there were in fact eight P3 projects that were delayed longer than 60 days – the longest more than a year off schedule. For six of those projects the contractor did face financial consequences, but in two they did not. That’s eight out of 38.
As health care providers news of the increase in minimum wage is important – as we stated in 2013, poverty is the second leading cause of death in this country.
While we have to applaud the government for finally promising to index the minimum wage to the cost of living – the legislation to do so has yet to be introduced – the reality is the adjusted rate simply didn’t go far enough. Even at $11 an hour, the wage is still 16 per cent below the poverty level for an individual who works full-time. And in Ontario there are a lot of people in that boat – the rate doubling since 2003 to 9 per cent of jobs in the province.
Kathleen Wynne told the CBC this morning that she was balancing the demands of anti-poverty groups with those of business, who warned that $14 an hour would lead to a loss of jobs. She said the government can use other means to help Ontarians get out of poverty, including the child benefit.
No doubt the business elites would be happy to have others pay the freight so that they can continue to pay workers a very low rate of pay while reaping significant rates of return for their shareholders. A low minimum wage essentially means we are willing to subsidize very profitable corporations so they can continue paying workers well below their true value. That includes increased health care costs.
More than a third of all minimum wage earners are working in the fast food industry. So how are these corporations doing?
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.
“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.
Memo: To the Honourable Kathleen Wynne, Premier, Province of Ontario
From: Your new pals at OPSEU Diablogue
Dear Premier Wynne –
Imagine our surprise when we discovered in today’s newspaper that the public sector unions are in fact running government. We have to give thanks to PC Leader Tim Hudak for pointing this out, because we had no idea this had taken place.
Anybody who reads our BLOG will note that we have had many recent differences, ranging from your government’s addiction to costly private-public partnerships to the present round of deep cuts to our public hospitals. We know, you don’t call them cuts, you call it restructuring (now that we’re friends perhaps you’ll let us know where this work is being restructured so our members can pursue jobs there).
We thought we would start off with a basic principle – public is better.
Here’s the proof: at the dawn of Medicare in Canada, we spent about the same percentage of our economy on health care as the United States. That percentage has since gone up for both of us, but at a much faster rate in the United States where the majority of health care delivery is in private hands.
In 2010, the most recent year we have comparable international data, the U.S. was spending 17.6 per cent of its economic output on health care – both public and private. In Canada we spent 11.4 per cent. While we could do a lot better, our spending is comparable to countries such as France, Switzerland, Germany and the Netherlands. Incidentally, for all the panic about rising health care costs, Canada also spent 11.4 per cent of its economic output on health care in 2009.
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.
The decision by Premier Dalton McGuinty to step down and shut down the provincial parliament leaves many questions about the future of Ontario’s health care.
With no parliament, there will be no review of the Local Health Integration Networks, a commitment that the McGuinty government wrote into the original Act that created the Crown agencies.
When the government wrote the Local Health System Integration Act in 2006, somebody forgot to calculate that a five year mandated review would take place just prior to a fixed date election. Whoops! McGuinty did suggest that such a review might not be necessary at all until someone reminded him that it was written into the legislation.
There was no way the government was going to undertake a review of the unpopular LHINs just prior to going to the polls. In recent months we had heard that such a review was finally going to go to committee. Now that won’t happen. That means it could be seven years before the five-year review happens.