Some updates on recent stories in the Diablogue…
We’ve been trying to assess in recent weeks how many of the 100 long-term care inspectors Health Minister Deb Matthews promised in June 2013 have actually been hired. The official word is now in: 89 – all of them temporary or “fixed term” contracts. January 13 we pointed out that the promise of having every nursing home receive a resident quality inspection in 2014 and annually thereafter will be difficult to fulfill if all these inspectors are intended to be on the job for only 12 months. It normally takes three inspectors – nursing, dietary and environmental — as long as two weeks to complete the full RQI inspection. This is on top of responding to more than 2,000 complaints each year from families and residents.
We’ve heard back from two more Local Health Integration Networks on their policy around making public board documents. The Welland Tribune tripped our interest in this policy after they suggested the Hamilton Niagara Haldimand Brant LHIN was the least transparent in the province, posting board materials as long as six weeks after the actual board meeting. Our January 7 post noted that four LHINs were missing from the newspaper’s survey and we decided to send them e-mails that afternoon asking about their disclosure policy. This is important given it can be difficult to follow the discussion at a LHIN board meeting without access to the documents (ie. briefing notes, minutes, reports) board members are referencing. It raises the question how “open” is an open board meeting? Most of the LHINs post their documents well in advance of board meetings or at least make documents available during the meeting. The first to get back to us of the four LHINs missing from the Tribune survey was Toronto Central, but more recently Central West and Mississauga Halton checked in, both indicating that they too offered more than an agenda to citizens attending their board proceedings. Central West, responding to our question on January 21, posts all board material seven days prior to their meeting. They also typically post meeting notices 25-30 days in advance. Central West deals with disclosure by noting all materials are in draft form until approved by their board. Mississauga Halton is not as open. It makes available board materials to the public at the actual meetings. Those not attending the meeting can request materials after the board meeting is complete. Minutes are made available online up to 30 days after the board has approved them. They post their yearly meeting schedule on-line at the beginning of the year and notify of any changes within the 10-days required under the Local Health System Integration Act. Mississauga Halton apologized for the 10 days it took to answer our question. Their response came January 17. That leaves just the North West LHIN to reply to our January 7 survey.
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.
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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
What is the value of a promise?
In some cases we have chastised government over the lack promises kept, such as the 10-year mental health strategy that never materialized. Or the lack of community-based resources that were supposed to replace a decade’s worth of hospital bed cuts. Or the long-delayed strategic plan for health care the Local Health Integration Networks were supposed to initially use as a guide for their own integrated health service plans.
In other cases, we’d rather hope the Minister of Health simply forgot some of her promises, such as the one to re-introduce competitive bidding to home care or base the decision to implement a resident quality inspection (RQI) on how many complaints and critical incidents a nursing home experiences. To her credit, both were policy duds and it appears were only offered up once and quickly abandoned.
Matthews has made many promises around fixing long-term care, as has her predecessors. Yet we get a regular serving of scandal on this file, evidence that the fix was either not happening or not happening quickly enough.
When we learned Monday that Matthews had taken the bold step of more than doubling the number of long-term care inspectors, we were both stunned and pleased by the news.
Oddly throughout the day we heard from a number of sources that Matthews had previously made this promise before and never followed through. The suggestion was we shouldn’t celebrate too quickly – at least not before we see the whites of the new inspectors’ eyes.