Tag Archives: Ontario Health Coalition

Kingston votes 96 per cent against hospital privatization

Kingston City Council's Jim Neill urges residents to vote on Princess Street.

Kingston City Council’s Jim Neill urges residents to vote on Princess Street.

It had all the trappings of an election. There were lawn signs, TV commercials, and door-to-door campaigners. The local media solicited the views of both politicians and citizens as everyone scrambled to become informed before the vote.

Saturday Kingston residents got the opportunity to express their preference on whether a proposed new hospital facility in their community was going to be entirely public or be under a 30-year finance and maintenance contract with a private for-profit consortium.

While this election wasn’t conducted by Elections Ontario or Elections Canada, it had the feeling of being the real deal. Citizens were given the opportunity by the Ontario Health Coalition to consider a private or public option even if the result will be non-binding.

After five weeks of public debate, the answer was clear. 96% of the 9,885 votes cast at more than 50 polling stations said yes to keep the new hospital entirely public.

We have had one “official” election on this issue before. In the 2003 provincial election Dalton McGuinty opposed privatizing public infrastructure, campaigning against two “public-private partnership” (P3) hospital deals set up by then Premier Ernie Eves.

Like the results in Kingston, in 2003 the public instinctively bridled against the idea of privatizing key elements of Ontario’s public infrastructure. It helped give McGuinty the first of his two back-to-back majorities. Ontarians were already aware of what a bad deal the province got from privatizing Highway 407. They were worried about the impact of deregulation and privatization of electric power, particularly after a devastating outage in August of that year that took out much of the continental northeast.

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A tale of two LHINs – Champlain could learn from Central East when it comes to community involvement

In the past few weeks we have been challenging the Champlain Local Health Integration Network (LHIN) to step up to the plate around cuts and transfers of services from The Ottawa Hospital.

Champlain LHIN CEO Chantale LeClerc has dug herself in for the fight, insisting that considerable changes to health service delivery in her region do not warrant an integration decision nor any additional public consultation.

Curiously, in her most recent letters to both OPSEU and the Ontario Health Coalition, she has suggested that regional volumes of endoscopies have not yet been decided and that the LHIN has no mechanism to transfer them outside of a hospital environment (LHINs have no jurisdiction over private clinics performing public OHIP work).

The Ottawa Hospital CEO Jack Kitts is publicly stating the hospital will perform 4,000 fewer endoscopies per year (initially it was 5,000 fewer) and that it was his expectation that these volumes would be picked up by independent community-based clinics and other regional hospitals.

Clearly the hospital CEO and the LHIN CEO are not on the same page even though the LHIN is telling us the hospital is merely following its accountability agreement.

Endoscopies will be coming under what are called “Quality Based Procedures” for the coming year. These QBP get funded separately from hospital global budgets. That means if The Ottawa Hospital decides to stop doing 4,000 endoscopies, it also stops getting funding for them. Unless TOH is losing money on these procedures, it doesn’t suggest that such cuts will do anything to aid their bottom line – the whole point of this “restructuring.” Until we know where these procedures are migrating to (if anywhere), we have no idea whether the region will be saving any money or whether the public will be maintaining access.

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Is competitive bidding in home care done? Let’s hope so.

September 10 Doris Grinspun, executive director of the Registered Nurses Association of Ontario, tweeted that Health Minister Deb Matthews had just announced to a nursing meeting that the moratorium on competitive bidding in home care would be made permanent. No formal confirmation of this announcement has been made by the Ministry of Health.

No services competition has successfully taken place since 2004 when then Health Minister George Smitherman announced the appointment of Elinor Caplan to conduct a review into the competitive bidding process.

The Caplan review followed months of campaigning in the Niagara region after the Victorian Order of Nurses had lost the local home care nursing contract during its centenary in the community. OPSEU-represented VON members had met with MPPs up and down the Niagara peninsula to point out problems with the competition.

The union complained that the bidding process had been tainted by the then Niagara CCAC administrator who told at least one patient in advance of the competition that VON would not be a successful bidder.

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September rally to demand health care commitments

Public health care usually ranks at the top of voter priority issues. It is also an issue that politicians are reluctant to talk about during the heat of an election. All three parties carry health care baggage from their time in government.

The Rae NDP government accelerated the privatization of community labs and created Rae days which increased overtime costs in hospitals. The Harris/Eves Tory government froze health care funding and introduce the disastrous policy of competitive bidding to home care. The McGuinty Liberals have closed ERs and pressured hospitals to empty hospital beds without providing sufficient alternate care in the community.

The Liberals and Tories are now promising to reduce health care spending increases to three per cent per year. Tim Hudak wants to eliminate the LHINs but offers no replacement for planning, funding, and community consultation. He also wants to contract out support services in our hospitals. The NDP have yet to reveal their health care platform. All this is taking place as governments prepare for a new age of austerity.

Regardless of the baggage they carry in to the election, voters need to demand a vision of where health care is going from all parties. It’s not just about shovelling funding into the system.

The Ontario Health Coalition is hoping that enough people show up in the streets of Toronto September 13th to send a message that political candidates cannot ignore. During this election we really do want to talk about health care.

The rally to safeguard public health care is being scheduled at Queen’s Park on Tuesday, September 13 at 12 Noon. While most rallies are aimed at the government of the day, this rally is a message to all parties that it is time for improved and equitable access to comprehensive health care across all of our communities.

Health care workers may want to schedule their shifts to be able to come to Toronto on that date. For workers along University Avenue and near Queen’s Park, the rally offers an ability to come out during lunch time and cheer the rally on.

Watch for more details in the coming months.

Meanwhile, please download the attached rally poster and share it with anyone you know who is interested in defending our public Medicare system.

Coalition hosts one-day briefing/summit on “ALC” issue

The Ontario Health Coalition is hosting a one-day briefing and summit on retirement homes and alternative level of care.

Ontario hospitals are presently under tremendous pressure to relocate “alternate level of care patients” — patients who are finished their acute care treatment but are not well enough to go home.

Increasingly they are being sent to retirement homes, which are ill equipped to provide the level of care many require.

The Coroner’s office has issued warning to the Ontario Hospital Association about inappropriate placements of patients to retirement homes.

The government requires retirement homes to abide by standards of long term care in order to accept such patients, but is it enough, and are these standards really being met?

How can we best protect the comprehensiveness and accessibility of Ontario’s health care system for those with chronic care needs?
How can we best protect patients, residents and staff from harm?

High-Level Briefing and Summit
June 20, 2011
Lillian H. Smith Public Library
239 College St., Toronto
Registration 9 am – 10 am, Adjournment 3 pm

Registration is $0-$10.

Sponsored by: Ontario Health Coalition; Alliance of Seniors/Older Canadians Network; Older Women’s Network.

How to lose a public health care system – Leys speaks to activists in Toronto

UK professor Colin Leys spoke to health care activists May 16th in Toronto. The event was organized by the Ontario Health Coalition.

It’s not a simple matter for a western democracy to lose a public health system. Citizens strongly support tax-funded public systems. In Canada, we believe it to be one of our defining features.

Yet in England the National Health Service (NHS) is being gradually eroded and taken over by giant U.S. health maintenance organizations (HMOs) and run increasingly on market principles.

What is more frightening, is the gradual approach in England has strong parallels to Canada.

UK professor Colin Leys has documented this transition from a public health care system to a market-based one in his new book, “The Plot Against the NHS.”

Meeting with a group of health care activists May 16 in Toronto, Leys pointed out the irony of the U.S. having the most inefficient health system in the world and exporting it now to other countries.

Leys said that current initiatives of UK Prime Minister David Cameron’s government were made possible by a decade of gradual market initiatives under the Labour government of Tony Blair and Gordon Brown. While Scotland and Wales have turned back towards a more public system, England continues the march towards a more Americanized system.

Cameron’s new health care bill would leave it up to consortia of doctors to determine how public health care funding is spent. Many of these consortia are in fact owned by private for-profit companies such as the U.S. health care giant UnitedHealth and Virgin, better known for operating record stores. Given doctors have little or no experience in buying or “commissioning” health care services, private firms are moving in to take up this role.

The ability of these general practitioner commissioning bodies includes discretion over what services they will buy and which should be publicly available.

That includes buying public health services from “any willing provider” approved and registered by the system monitor.

“The bill also removes the duty of the Secretary of State for Health to provide a National Health Service,” says Leys.

What has angered many in England is the fact that Prime Minister Cameron has done this without any discussion of the bill in the UK’s last election.

In fact, “Cameron promised no more top-down reorganizations of the NHS,” says Leys.

Leys says the new bill will mean the loss of comprehensiveness through delisting – something the professor says is already taking place.

It is also likely the bill will pave the way for more user co-payments as cash-strapped health foundations respond to cost pressures.

Leys says that while Cameron “pretends” to exempt the NHS from cuts, the reality is more of the system funding is being siphoned off into “social care,” creating a net real cut.

The new bill also takes a cap off of the number of private patients English hospitals are allowed to take on, shifting the hospital model to focus on raising money through more private patient income.

Many doctors assumed that because their trusts are no longer answerable to the Department of Health that there would be more freedom from bureaucratic control, says Leys. Instead they are now even less free under the new private model.

While many of these shifts to market-based health care were taking place under the labour government, the UK government dramatically increased public funding to more closely resemble their peers in the rest of Europe. The results were improvements in wait times that were mistakenly attributed to increased privatization.

Leys says there are many holes in the new act, including no provision for failing hospitals.

Nor is there any approval process when a private company sells their assets to another.

The debate rages on in Britain. The Royal College of Nurses has passed a no-confidence motion in the plan, which has in turn stiffened the resistance of many of the country’s doctors, says Leys.

Given the complicity of the Labour Party in setting up these reforms, the official opposition has been noticeably muted in its criticism.

Cameron has recently told the media he would not allow private companies to cherry pick the NHS, that there would be no privatization, and that patients would experience no up front costs.

Within days of promising this, news reported that the Labour Party leader would have to pay for surgery on his nose because it was considered to be a low priority for his local health care trust.

The Ontario government has closely followed the path of health care changes in the English NHS. At present Jim Easton is touring the province speaking to groups such as the Ontario Hospital Association and the Ontario Association of Community Care Access Centres.

Easton is the NHS National Director for Improvement and Efficiency. It has been his job to cut billions of pounds out of the NHS.

The timing of Easton’s tour suggests the McGuinty government is seriously considering rolling back health care costs on this side of the Atlantic too.

Given years of Ontario’s own changes to a market-oriented health system, we may be paving the way for similar reforms should Tim Hudak’s Tories come to power.

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.