The Ontario Hospital Association must be finally feeling the pinch of fiscal restraint and so-called “funding reforms” that have worked against their bottom line for at least the past four years.
The OHA is asking that the government begin doing capacity planning – forecasting the specific need for a full range of specific health services. That not only includes forecasting the need for hospital services and beds (including types of beds), but also includes (but is not restricted to) a provincial needs assessment for long term care, assisted living, home care, primary care, and mental health services.
The ask was part of a rare Saturday press release, itself a follow-up to the OHA’s presentation to the Standing Committee on Finance and Economic Affairs last Thursday.
No doubt the OHA sees capacity planning as the first step in getting them out of the stranglehold the province has placed them in with declining real funding. The OHA has seen freezes in base funding for the past two years, and the two years before that funding was restricted to 1.5 per cent – well below what is needed to maintain the status quo.
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.