Last week’s provincial budget was accompanied by an uncharacteristic snippy release from the Ontario Hospital Association expressing disappointment.
While OHA CEO Pat Campbell says there are a few positive initiatives for hospitals and the health care system, the chief complaint is over the lack of a comprehensive capacity plan.
That’s likely a fancy way of saying the government is cutting the heck out of us, putting some of that money elsewhere, and hoping it all balances out okay. If we are looking for any more sophistication than that from government, we’re likely to be disappointed.
Health Minister Deb Matthews has repeatedly said that downsizing hospitals in favor of more community based care is the plan. In the budget they go as far as listing endoscopies, dialysis and vision care as the next wave of services to be divested to not-for-profit clinics, even if no evidence is presented on costs.
In March Deb Matthews told the media that 36 hospitals will have their budgets cut by as much as three per cent when this year’s new hospital funding formula rolls out.
This week the Ministry held a technical briefing and remarkably told its labour stakeholders that in year one about 10 per cent of hospitals will see increases in funding no greater than 1.8 per cent and decreases no greater than 1.5 per cent.
They also state that 90 per cent of hospitals will see less than a one per cent difference in their budget allocation, plus or minus.
Back in March 91 hospitals were expected to “benefit” from the new formula. Now the Ministry says only 90 hospitals will participate – small rural and northern hospitals being excluded from the Health Based Activity Model (HBAM).
That’s a big difference.
In Ontario, when a health policy fails, it appears you expand it.
For four years Ontario has been attempting to use payment-for-results (P4R) funding to improve ER wait times. As we reported recently, only about a fifth of the P4R money allocated to hospitals in the Central East region was distributed this quarter, the rest – more than $4 million – was returned to the Ministry of Health. The hospitals couldn’t reach the targets set for them.
Sending more than $4 million back to the Ministry of Health will not help them reach those targets any faster.
Queen’s Park is fixated with the idea that only competition for cash can lead to improved wait times. On the other hand, they expect the system to integrate with more cooperation between providers.
These are not compatible ideas.