Tag Archives: OPSEU

New Video: Faces of Support – Making Ontario’s Hospitals run effectively

This new video looks behind the scenes at the contributions highly skilled support staff make to the daily running of a hospital. It is a big mistake to assume these individuals are expendable during times of austerity — experience tells us these workers are key to making hospitals both safe and efficient. Clearly from the stories they tell, what patients also value is a smile and someone who treats them with dignity. This video was shot last year at York Central Hospital in Richmond Hill and at the Kingston Hotel Dieu Hospital as a project of OPSEU’s Hospital Support Division.

Faces of Support (2012) 14 minutes – Featuring Jill McIlwraith (Chair, OPSEU Hospital Support Division), Warren “Smokey” Thomas (President, OPSEU).

Click here to watch the movie:


Video: After the Storm – Occupy Toronto Day 6

OPSEU President Warren “Smokey” Thomas arrives at Occupy Toronto with Indian take-out for 400. The day after a violent thunderstorm and heavy rains, the tent city continues to expand despite the mud and damp. Solar generators have arrived with the promise of making the camp even more self-sufficient. Christmas lights are found in the logistics tent, suggesting this is going to be a long stay.

The trouble with LHINs

Local Health Integration Networks (LHINs) have become lightning rods in many communities.

The Hamilton Niagara Haldimand Brant LHIN was the focus of a scathing Ontario Ombudsman report “The LHIN Spin” which suggested public engagement was no more than lip service.

The South East LHIN recently sent their local communities into a panic after it floated the idea of concentrating all surgeries in Kingston.

The Erie St. Clair LHIN generated headlines last year when it unveiled plans to bring in a Disney speaker at a cost of close to $10,000. The speaking engagement was cancelled, although not the cost.

Aside from a horrible name, the LHINs have made many blunders to turn Ontarians against them – at least among the citizens that are even aware they exist.

68 per cent of PC supporters oppose plan to kill the LHINs

In a February 2011 Vector Poll, only 22 per cent of respondents claim to have either heard or read something about LHINs. Vector has been polling this question since 2006 with barely a change in results. After a brief description of what the LHINs do, 77 per cent of Ontarians opposed shutting them down. More troublesome to PC leader Tim Hudak, 68 per cent of PC voters are opposed to his promise to kill the LHINs.

It’s like that old song, “I can’t live with you, but I can’t get along without you.”

If the LHINs are likely here to stay, how do we fix them?

For starters, it’s about time the province come up with its overall strategic plan. It was supposed to be the guide for the LHINs to develop their own regional integrated health service plans. Instead, the province has been flighty in its priorities, often changing from Minister to Minister. George Smitherman was all about aging at home. David Caplan was about mental health. Deb Matthews is focused on getting alternate level of care patients out of hospitals.

Secondly, the LHINs are likely too small and have too few professional staff to effectively carry out their work. They like to crow about how small their administrative costs are relative to funding they shell out to hospitals, long term care homes, home care and other health providers, but it may be unreasonable. The Ministry has added to the workload with additional performance indicators and a broadened scope of oversight, but it refuses to allow the LHINs to hire appropriate staff to get the job done.

This may have something to do with point three – the LHINs have been very focused on reigning in costs, mostly at hospitals. It would be political folly to add to the LHIN administration while front line health professionals are being cut. This was supposed to be an exercise about quality, but clearly the focus has been on cost. One hospital CEO showed up at a LHIN board meeting to discuss progress on his hospital’s improvement plan. Missing from his presentation was information about the hospital’s performance on the LHIN’s quality indicators. To their credit, Ontario hospitals are in a far better place financially today, but it may be at a cost in quality.

The LHINs were supposed to take their strength from the communities they served, but no community has really warmed up to them. A few years ago OPSEU was invited to participate in a panel discussion on the LHINs by the Rural Ontario Municipal Association (ROMA). When the floor opened for questions, Mayors and Councillors of small towns lined up at the microphone to vent their frustration with the LHINs. The mayors felt the LHINs were unaccountable and were carrying out a hatchet operation on their local hospitals.

When a matter of concern comes up on the LHIN board’s agenda, often communities show up in considerable numbers. The LHINs lack any mechanism for representatives of these communities to address their concerns directly to the board. Recently two LHINs opened up their board meetings to deputations, although the process at Central East may be far too onerous and controlling to ever work.

When the LHINs did hold events for public consultation, these events often involved round tables with facilitators and set question lists. Many who have attended these events found the process manipulative.

When OPSEU took the Central East LHIN before judicial review in 2008, the lawyers for the government argued the LHINs were only responsible for high-level consultation, not on specific changes. In other words, the LHINs could ask what kind of health services a community might want, not on whether 20 mental health beds should be shut down at their local hospital and moved to another community.

It’s these specific initiatives when the public is most engaged, and it is these moments when the LHIN shuts them out of the process.

There are signs the LHINs are beginning to learn from their mistakes. At a recent Central East LHIN meeting they said they looked at integration between two addiction services and realized that while cooperation between the two of them was encouraged, it didn’t make sense for them to merge. The LHIN also acknowledged that Lakeridge Health was a good place to host one of these two services – a radical departure from the LHIN’s early days when it seemed they couldn’t move services out of hospital fast enough nor convince enough providers to integrate. This is the same LHIN than asked hospitals to set aside 1 per cent of their budget to allocate to a community-based health provider while trying to maintain it was making evidence-based decision-making.

There is a value to have a process by which health care providers must justify changes in service delivery.

The Southwest LHIN recently put the breaks on a plan by Grey Bruce Health Services to jettison speech language therapy for preschoolers. The hospital made the announcement under a hope and a prayer that the Health Unit would be able to pick up the work. The LHIN has since written to the hospital asking them to submit a formal integration proposal. Such a proposal will require more than a hope and prayer in the transfer of a service — it will need a HR transition plan.

The South West also responded to complaints that the Regional Mental Health Centre in London and St. Thomas was cutting beds without providing appropriate alternate services in the community. The LHIN allocated another $2.9 million for community delivery of mental health as a result. It won’t be nearly enough, but at least there was evidence they are listening.

It is far more productive to start talking about what the LHINs or their replacement might look like rather than take an axe to it all as Tim Hudak proposes. Diablogue will write more on this in the weeks to come.

Windsor hospital CEO uses OPS deal to attack hospital workers

What does a one per cent increase for the Ontario Public Service have to do with Windsor Regional Hospital? Answer: very little.

Yet this morning the hospital’s CEO made the front page of the Windsor Star attacking the agreement, which does not directly impact staff at the hospital.

It’s true that all wage settlements are subject to comparison at the bargaining table, and it is likely WRH CEO David Musyj will try and introduce the lowest comparators he can find. If the two sides cannot agree, an arbitrator will look at all the submitted comparators. That’s the nature of the process.

OPSEU does not shy away from negotiating the best contracts for its members. During a recession it’s not unusual to have the final years of a multi-year contract make up for lower increases in the early years.

Musyj says both the arbitration and negotiation process is broken. How so? This is the same CEO who claimed he couldn’t afford $3.6 million in salary increases while the hospital was receiving more than $10 million in new money and audited statements revealed he was actually sitting on a surplus. Better still, the spring budget revealed status quo for the hospitals, forestalling reductions in the rate of increase that had been forecast in the 2010 budget. That means Musyj will likely see that surplus increase.

Musyj says his office is expected to reduce expenses by 10 per cent, but that doesn’t necessarily mean he will be taking another cut in pay (the latest Sunshine list showed Musyj took a cut in pay to $254,847 in 2010 from $265,000 in 2009). The government has made it clear that it will not penalize hospitals that fail to do so. With a surplus, what is Musyj’s motivation for doing so?

The question comes down to this: we are now emerging out of the recession, why is it would-be politicians like Musyj still trying to reduce the standard of living of working people? As we have noted repeatedly, the same thing was never asked of profitable corporations who are seeing their taxes cut to record lows.

It’s already party time on Bay Street and Wall Street.

This morning the economy posted stronger than expected job numbers, suggesting Ontario is bouncing back from the recession. That means more revenue for the government, and by extension, its hospitals. Where’s the panic?

Musyj is playing politics at the expense of the morale of his staff. This is far from good leadership.

LHINs claim benefit of local decision-making amid attacks from Hudak

The Local Health Integration Networks (LHINs) appear to be making an effort to communicate their value amid increasing attacks from provincial PC Leader Tim Hudak.

Hudak is campaigning hard on a platform of eliminating the LHINs. The problem is, he has never said what he would replace them with.

In today’s Sudbury Star, Louise Paquette, CEO of the North East LHIN, makes a pitch about the importance of LHINs making decisions locally, despite the fact that the geography of her LHIN runs from Parry Sound to Hudson’s Bay and North Bay to Wawa.

April 2nd Gerry Macartney, CEO of the London Chamber of Commerce, echoes Paquette’s comments in the London Free Press, claiming “all decisions are made in our community at open, public board meetings.”

Macartney met with the South West LHIN’s CEO Michael Barrett and came away a convert, claiming that while not perfect, the LHINs “are a huge improvement over what was there before.”

The LHINs do provide some level of process and planning to changes in the health system, but it is far from consistent. It is also sometimes overstated – Paquette claims credit for reduction in wait times while remaining silent on the substantial transfers of cash from the Federal government and the province.

Having a LHIN in place has made a difference. A decision this spring to close a community-based transitional mental health facility was put on hold by the Central East LHIN after we raised questions about the lack of planning for patients who resided there.

At the beginning of this month we raised questions about a botched transfer of a preschool speech and language program from Grey Bruce Health Services to the Grey Bruce Health Unit.  Unable to come to an agreement as to how these services would transfer, the hospital simply issued layoff notices to the speech language pathologists and their assistants. The Health Unit is now attempting to recruit the same people.

The problem is, the hospital has yet to submit an integration proposal to the South West LHIN as required under the Local Health System Integration Act. That integration proposal is supposed to have a HR plan — something clearly missing.  They are shooting first, asking permission afterwards. The LHIN informs us they have notified Grey Bruce Health Services that the proposal must be treated as an integration.

If there is one profession health care providers have particular difficulty recruiting, it is speech language pathologists. On average, it takes a health care provider a year to recruit a SLP in Ontario. Should these individuals decide to take their experience elsewhere, the health unit may face difficulty maintaining the preschool speech and language services the hospital formerly provided.

In 2008 the South West LHIN received a report from their Children and Youth Priority Action Team. The team recommended greater integration between providers of adolescent and youth services, including speech language therapy. They also stressed the need to have more equitable service throughout the LHIN, particularly in the north – represented by Grey and Bruce counties. It is not clear how transferring the service outside the scope of the LHIN will help integrate the program with other services within the LHIN.

Media reports suggest the decision had been made by the Ministry of Children and Youth Services, which only partially funds the service.

So, will we actually see a real decision, or will the SW LHIN make another decision after the fact?

It wouldn’t be the first time – Regional Mental Health London and St. Thomas issued layoff notices to staff long before the LHIN was able to rubber stamp plans to move their work to Cambridge. This January the Central East LHIN approved an integration after the agency had already closed its doors at the end of December. The question is, when the activity happens before the decision, is the LHIN really making any decision at all?

Given the SLPs and their assistants will be finished at the hospital in August, there is little time left to make a real decision. There are enough questions here for the LHIN to do more than wield a rubber stamp and claim how important local decision-making is.  Stay tuned.