How much of a factor is underfunding to the working relationships within a public hospital? What is the impact of resulting cuts on the public’s perception and trust?
In July Ken Deane’s final report was submitted to Health Minister Deb Matthews. Deane was appointed supervisor for the Windsor Hotel-Dieu Grace Hospital after a series of public incidents that shook the community’s confidence. His report was made public a month later.
Deane sums up the so-called “difficult” period the hospital went through. Those issues include “a tragic murder/suicide; medical errors, and pathology mistakes that resulted in an investigation into surgery and pathology; an external review of cardiology; fraud in the finance department; termination of a vice-president and a related $6.3 million lawsuit against the hospital and specific staff; ministry announcement that it will appoint a provincial Supervisor; removal of the Board Chair by the sponsoring organization; and a subsequent resignation of a Board member.”
While Deane casts the usual blame on the dysfunctional relationships between the leadership of the hospital and the constant conflict within the organization, he does highlight financial stresses that may not rest entirely with the hospital.
Deane makes a particular plea to the Erie St. Clair LHIN noting the hospital provides substantial specialized regional services without accompanying compensation. Deane notes that the hospital has the highest “acute specialization index” (ASI) among Ontario community hospitals and 11th highest overall in the province. The ASI measures the per cent of hospital inpatient activity that is identified for specialized services or programs. Deane also identifies HDGH as having the highest resource intensity weight (RIW) of any community hospital in the province. The RIW measures the relative expected cost to care for a patient, suggesting a very high intensity level. While the new provincial funding formula does take these measures into consideration, Deane notes these issues have been identified to both the LHIN and the Ministry of Health for redress.