Tag Archives: OHA

OHA silent about sudden departure of CEO and President

Pat, we hardly knew you.

A year after being appointed OHA CEO and President, Pat Campbell has mysteriously disappeared from the OHA.

In a remarkably short announcement June 12, the OHA notes that its Board of Directors has appointed former Mike Harris aide Anthony Dale as their interim President and CEO effective immediately.

It has been a rocky road for Campbell.

This spring she looked less than stellar in responding to the CBC’s Rate My Hospital program.

The same month former OHA CEO Tom Closson publicly disagreed with her interpretation of the Quality of Care Information Act after the Humber River Regional Hospital mistakenly declared a newborn baby dead and claimed the results of their investigation had to be kept secret.

In May the OHA was uncharacteristically snippy about the provincial budget, complaining both about the lack of planning and the refusal of the Wynne government to rig the arbitration process in favour of the hospitals.

Continue reading

Hospitals: Who is earning more than the $418,000 proposed BPS salary cap?

The Ontario Hospital Association is disappointed again.

This week Dwight Duncan announced the government’s intention to cap salaries for new employees in the broader public sector – including hospitals – to $418,000 a year, or double Dalton McGuinty’s salary.

The idea had gained some traction in the last election when the NDP proposed it as a way of reining in rising executive salaries in the broader public sector.

The OHA issued a release this week in which they used the 2010 public sector salary disclosure to show that only 77 of the 207,000 people employed by Ontario’s hospitals earned more than $418,000 per year. Assuming those folks were rolled back to double the Premier’s salary (which Duncan is NOT proposing) it would save $4.7 million. If applied to all BPS employers, it would amount to $7.3 million.

Given it only applies to new employees, the University Health Network’s Bob Bell, for example, would get to hang on to his almost $754,000 earned in 2011.

“This is another example of the Government of Ontario and legislators devaluing the work and skills of hospital leaders, and those who lead Ontario’s vital BPS organizations,” the OHA said in the release.

Obviously OHA President and CEO Pat Campbell trotted out the 2010 figures because they happened to be on hand from last year’s response to the NDP campaign pledge. We actually took a look at the 2011 disclosure and found one less body in the more than “double the Dalton” club. However, with all those registered nurses barely creeping into the sunshine list, it would be easy to overlook a couple of high flyers.

Continue reading

Is the OHA next to experience public wrath over executive bonuses?

It seems there are two choices with regards to executive compensation.

The first is to simply place executives on salary and expect them to do the job they get paid for. That’s how rank and file employees get paid.

The second is to divide compensation, setting out a certain amount as “base” salary, the rest as bonus based on established performance benchmarks.

The Local Health Integration Networks can also claw back a percentage of a hospital CEOs salary if the hospital fails to live up to the terms of its accountability agreement with the LHIN – not that we are aware of this ever taking place.

The LHINs themselves may be a bit gun-shy about using these powers given they themselves are struggling to meet their own performance targets. The Erie-St. Clair LHIN, for example, missed 11 of 14 performance targets for 2010-11.

Continue reading

Much hype but little scandal in hospital contract disclosure

The media have been on a feeding frenzy today around Tuesday’s disclosure of hospital executive compensation packages. Like the sunshine list, it is a chance for the private sector to paint a picture about how the public sector has been wining and dining on the taxes of the downtrodden, even if it is less than true.

The real story is there are really no big revelations here.

The most shocking example we found appears to be the work of sloppy reporting rather than executive excess.

The Toronto Star reported that Dr. Robert Howard, CEO of St. Michael’s Hospital, was receiving “a $75,000 allowance for a car.” This would lead most people to believe Howard was getting $75,000 each year to apply to a lease or purchase of a vehicle. In fact, had the reporters been a bit more careful, they might have figured out that it was for a lease or equivalent for a car whose retail value was up to $75,000. Nice, but at this level, ho-hum.

Continue reading

Ontario hospital data less than timely, transparent

How transparent is data from Ontario’s hospitals? And does it really tell the true story?

In July the far right Fraser Institute took a shot at Ontario hospitals claiming they lacked transparency when it comes to reporting performance indicators.

The Ontario Hospital Association shot back, claiming the Fraser Institute was likely unaware of  www.myhospitalcare.ca –an OHA site that provides data on more than 40 performance indicators.

The release quotes OHA President Tom Closson as saying Ontario’s hospitals are among the most accountable in Canada. The question is: how does Closson come to that conclusion? Is the OHA web site intended to be the evidence to support such a claim?

It’s true that there is a lot of public information on hospital performance, although what gets reported varies from hospital to hospital, the manner in which it is reported is often difficult to understand, and the information is usually less than timely.

The information is also in different places. Some of it is on individual hospital web sites. A select number of indicators are on the OHA site. Wait times information is on a Ministry of Health web site. To complicate matters, the information reporting dates are not the same on these sites, leading to conflicting data results.

It is also not unusual to see wild swings in the information reported, leading to questions about the quality of the data.

If you look up the Niagara Health System (NHS) on the OHA’s site, the infection rate for C-Difficile is similar to many other hospitals, although above the provincial average. That may have something to do with the fact that the data was collected in February of this year. Similarly, the Hospital Standardized Mortality Rate for the NHS is above average but below many other peer hospitals. These numbers don’t tell the real story – the Niagara Health System has recorded 37 C-Difficile-related deaths this year – so far.

In the age of real-time technology, is it reasonable for the public to try and make decisions based on data that is often more than six months old?

The OHA specifically cautions about using standardized mortality scores in determining which hospital to go to, instead suggesting such data should be used to track the performance of the hospital. What’s the point of standardizing such scores if they are not meant for outside comparison?

At the Local Health Integration Network board meetings, explanations over how to interpret this data are frequent. Yet the public is expected to go to web sites and understand such concepts as compliance with pre-surgery antibiotics, percentage of near miss reporting, or how inpatient weighted cases are determined. Could there not be at least a glossary and some explanatory notes to go with this data?

Try and decipher this reported action on the Peterborough Health Center web site: “Monitor and review VAP and CLI cases, rates and compliance with Safer Healthcare Now! Bundles.” Reading this, I’m sure the public can sleep more soundly now.

Clearly there is a need to provide a more simplified overview that puts this data into a more meaningful context.

Often data is hiding in plain site – on some hospital sites there is so much of it, finding what you are looking for is a considerable challenge on poorly organized web sites.

The myhospitalcare web site does provide provincial averages, but it does make it difficult to look at comparisons without going to each specific hospital location on the site.

Closson’s pronouncement of Ontario’s transparency ignores the fact that the province is the last to bring hospitals under Freedom of Information legislation. Ontario hospitals finally come under the Freedom of Information and Privacy of Privacy Act in 2012, but the OHA successfully fought to bring in additional exemptions for quality information as part of this year’s budget bill. In fact, the broad-based wording of the exemption will allow hospitals to conceal considerable information from prying eyes looking for public accountability.

Curiously, the OHA recently posted its advice to hospitals about the upcoming FIPPA deadline. You need a login and password to read it.

Ontario is also the last province in Canada to open up public hospitals to the scrutiny of the ombudsman. This is one office that has the expertise to cut through the dense jargon OHA members use in their reporting and to demand the data that isn’t publicly posted.

Last October Osler, Hoskin & Harcourt LLP raised eyebrows when they sent out an information bulletin warning hospitals that they should be “cleansing existing files on or before December 31, 2011, subject to legislative record-keeping requirements.” Osler was warning Ontario hospitals that they could face the same kind of reputation risk as e-Health if they failed to do so.

While there was shock and dismay, nobody knows to what extent Ontario hospitals took that advice to heart.

It is interesting that Closson used the word “accountable” and not “transparent” in the OHA’s defense.

Clearly there is a way to go for hospitals to be transparent in a truly meaningful way.

Lack of civility as opinions differ

This week OHA CEO Tom Closson wrote to a number of groups opposing the recent “hospital secrecy law” (Schedule 15 of Bill 173) that will allow the Ontario Hospitals to shield specific quality information from the public.

Given Schedule 15 had alredy been amended — presumably to the OHA’s approval — it is questionable as to the purpose of Closson’s sudden enthusiasm for letter writing. The actual amendment passed at the legislature’s finance and economic affairs committee Thursday morning.

What is most surprising from Closson’s letter-writing is his accusations that public interest groups were attempting to “grossly mislead” the public about the meaning of the Bill. The letters, all posted the OHA’s website, manage to insult the community organizations in a way we haven’t quite seen before.

He says Cybil Sack (Impatient4Change) “took significant liberties with the facts…while also making derogatory comments about hospitals, their leaders, and the professionals who work in them.” He further writes “it is apparent from your note that you believe the people who work in hospitals spend their days devising new ways to stifle public debate.”

To many of the organizations – including the Ontario Health Coalition, the Registered Nurses Association and the Service Employees International Union, he says he is writing to “rebut the grossly inaccurate claims.” He finishes all the letters with “on an issue as important as Ontarians’ health and safety, the “facts optional” approach your organization has taken to date is simply irresponsible. Ontarians deserve better.”

If these submissions were full of factual errors and misleading commentary, one might understand. Closson’s rebuttals fail to point out much in the way of factual error, but instead revisits the OHA’s original argumentation around the need for the schedule and takes issue with some of the intervenor’s interpretation of the role of the Quality of Care Information Act.

To suggest on this basis that anybody is trying to “grossly mislead” is a bit much. It also calls into question the OHA’s attitude towards public engagement.

By any interpretation, the government has opened the door to hospital transparency, and closed it to a degree with this amendment to the Freedom of Information and Protection of Privacy legislation. That’s a fact.

Closson is not the only one getting in on the act of incivility.

Georgina Thompson, Chair of the South East LHIN, recently told the media that prior to the LHIN’s recent Road Map plan, hospitals “talked to each other but they didn’t play together in the sandbox well.”

We could be wrong, but some hospitals may take umbrage to their characterization as children who got straightened out by the LHIN.

It’s been a long cold and wet spring. Here’s hoping that with a bit of better weather we can all go back to debating health care policy without this kind of nasty rancour.

Oh, and Tom – no need to reply.

Groups attack amendment that would protect hospitals from providing quality information

It was supposed to be a day of hearings on the provincial budget, but the insertion into the Act of an amendment to the Freedom of Information and Protection of Privacy Act that would exempt hospitals from providing information on quality had many individuals and organizations up in arms. Is the government getting anxious about its decision to open public hospitals to scrutiny? Schedule 15 in Bill 173 would exempt hospitals from divulging “information provided to, or records prepared by, a hospital committee for the purpose of assessing or evaluating the quality of health care and directly related programs and services provided by the hospital.”

Hospitals are to be subject to Freedom of Information beginning January 2012.

This is what some of the April 20 deputations to the standing committee on finance and economic affairs had to say on the issue (from Hansard):

“There’s absolutely no evidence that giving more information to patients means that lawsuit numbers will rise; in fact, the evidence is exactly the opposite. In the United States, where a few hospitals have taken the courageous position that regardless of the circumstances, patients are entitled to know the full details of errors—and the hospital has even assisted patients to file a claim—lawsuit numbers have plummeted, and the amount of money that is paid out per lawsuit is reduced. That’s the truth of what happens. Do you know why? If you think about it, you have a close relationship with the people who are looking after you in a health care setting. You don’t want to sue them. The people who come to me are not chomping at the bit to sue doctors and nurses; they’re doing it because it’s their last option, because they’ve tried other things and it hasn’t helped.”
–       Amani Oakley, medical malpractice lawyer

“I sued in frustration as a last resort, so that the truth would be told in the death of my father. Unfortunately, that has yet to happen. I wanted, and am still actively seeking, accountability, justice and transparency in the Ontario health care system in its entirety, and access to information that, in a democracy, must be available to the public.

I was offered the sum of $10,000 by University Health Network and the medical transportation company involved and told that if I took this money, I could never speak of my father’s case again or I would be sued. I refused this money, as I considered any monetary compensation as blood money, because this would not bring back my father and it would not right the wrong that had occurred, especially for people who still put their lives in jeopardy using the Ontario health care system.”
–       Lorraine Blue

“We in Niagara want, therefore, to have access to everything that the NHS and the LHINs have discussed under quality of care. Without that, we will not be able to have a full investigation, either under this government or a subsequent government. Without a full understanding of what has gone wrong—and this is not to put blame. I do not believe, and most of us do not believe, that we’re talking about individuals here at all. There has been a system breakdown because of the speed in having to do things and also because of financial constraints on an overly large amalgamated hospital.”
–       Fiona McMurran, Welland resident

“It boggled my mind when I saw this amendment, after the government had come so far in terms of opening up hospitals to freedom of information in the first place. No other province does this. All the other provinces open hospitals up to freedom of information. We’re the last province to put hospitals under freedom of information.”
–       Rick Janson, OPSEU staff expert on health care

“The hospital industry maintains that FIPPA will undermine patient safety culture, but has presented no data and no concrete example. The facts suggest that whatever is going on behind closed doors now is, in any event, ineffective. Recent data shows that adverse events in hospitals remain frustratingly high. The Canadian Medical Association recently estimated that between 9,000 and 24,000 deaths in hospitals across Canada were preventable.”
–       Paul Harte, President-elect of the Ontario Trial Lawyers Association

“Imagine our surprise when a question was put forward regarding schedule 15 and our honourable health minister said that this was added for patient safety. In our opinion, schedule 15 does just the opposite. Patient security and privacy is already covered by the Personal Health Information Protection Act.

The impact that this will have on Ontario’s health care system could potentially be frightening. Hospitals which engage in poor practices will be protected from scrutiny, potentially resulting in numerous victims. Even if your family doctor wants to access information regarding a hospital’s record of quality before he sends you there, access can be denied.”
–       Ed Vander Vegte, Niagara chapter of the Association for Reformed Political Action

“I’d like to know more clearly what it is that they’re concerned about. The examples that have been given so far don’t hold weight; they certainly don’t meet a public interest test. If there is something there, then we’d like to know what it is, but we haven’t been given that information. It certainly doesn’t belong in a budget bill and certainly not with the very short period of consultation that we’ve been given to date. There’s only one hearing; it’s only in Toronto. It’s just not the right way to do this properly.”
–       Natalie Mehra, Ontario Health Coalition

“RNAO agrees there is a need for protecting the identity of hospital staff when engaged in quality-of-care discussions, as the threat of disciplinary proceedings could indeed hamstring such discussions. On the other hand, it would not inspire great confidence in the hospital or the health care system if hospitals refused to release quality information for fear of litigation.

This approach is very different to the one the Ontario Hospital Association and its members demonstrated when they participated in the important and popular hospital report card series, allowing many facility-level quality indicators to be released publicly. That showed bold leadership. Unfortunately, the public no longer enjoys access to this window on the hospital system, as it was terminated in 2008.”
–       Kim Jarvi, Registered Nurses Association of Ontario

“The number one thing I hear about is not lawsuits. It really isn’t. It’s not the money. It’s not even an apology, because with the Apology Act, it doesn’t mean much. It’s not even disclosure; that’s just the first step. What people really want is to know that what happened to them did not happen in vain, that we’re learning from it, that we’re measuring the change and that we’re accountable to that change, so that they know nobody else has to go through what they went through.”
–       Cybele Sack, ImPatient for Change

“In my opinion, I believe it is time for Ontario citizens to have full transparency and accountability in all matters related to the health care they receive. I also believe that our health care should reflect the human and democratic right we each have as Canadians to have a quality health care system regardless of age, race, ability or gender.”
–       Kim Hessels, “mother of a child with special needs”

“You’re being asked to throw a large blanket of protection of secrecy over anything related to quality within a hospital, and quality care makes up the core, the essence and many of the functions that hospitals perform for the public.”
Eoin Callan, SEIU

Conspicuous by its absence was the Ontario Hospital Association and the Ontario Medical Association, which had lobbied for the exemption alongside a major malpractice insurance company.

To read the full transcripts, go to: http://www.ontla.on.ca/web/committee-proceedings/committee_transcripts_details.do?locale=en&Date=2011-04-21&ParlCommID=8858&BillID=2475&Business=&DocumentID=25696#P56_3174