Tag Archives: The Ottawa Hospital

Transferring hospital services to private clinics — a line in the sand

Posted on May 23, 2013 | 1 comment
Code Blue in Ottawa: Marlene Rivier chairs a panel including (R-L) Maude Barlow (Council of Canadians), Mike McBane (Canadian Health Coalition) and Natalie Mehra (Ontario Health Coalition).

Code Blue in Ottawa: Marlene Rivier chairs a panel including (R-L) Maude Barlow (Council of Canadians), Mike McBane (Canadian Health Coalition) and Natalie Mehra (Ontario Health Coalition).

OTTAWA – Natalie Mehra says The Ontario Health Coalition is drawing a line in the sand when it comes to service transfers to private endoscopy clinics from The Ottawa Hospital.

Speaking at a “Code Blue” forum in Ottawa last night, the director of the coalition said the privatization of these hospital services were “unprecedented,” part of a series of changes that had become “divorced” from planning around patient need in the Ottawa region.

Mehra raised questions about the capacity of these private clinics to absorb 4,000 endoscopies, particularly when they were likely to lengthen wait lists.

Given endoscopies are going to be individually funded by the Local Health Integration Networks this year, funding normally allocated to the hospital for these procedures cannot flow from the LHIN to the private clinics given such clinics are outside the scope of the LHIN.

The transfer of endoscopies to private for-profit clinics also is in direct contradiction of the Ontario Health Minister’s commitment to transfer services to not-for-profit providers in the community.

Mehra also debunked the myth that the cuts to hospital services were merely part of a new reorganization of health care, noting the lack of funding support from Queen’s Park to home care over the last decade. Even with the recent funding increases, per patient funding is lower today than it was before the McGuinty Liberals took power in 2003.

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The Ottawa Hospital: Restructuring now called cutbacks?

Posted on March 22, 2013 | 2 comments

Last week we were in Ottawa publicly challenging the Champlain Local Health Integration Network to treat service transfers from The Ottawa Hospital as an integration decision.

There was a terrific media turnout for the press conference we shared with the Ontario and Canadian Health Coalitions.

Following the press conference, one of the local newspapers, the South Ottawa EMC, contacted Champlain LHIN CEO Chantale LeClerc for comment.

According to the EMC, LeClerc told them the cutbacks don’t count as an “integration,” so no formal consultation or board decision was required.

Cutbacks?

Up until now the Minister of Health and the LHIN had maintained changes at the hospital were about health care restructuring.

Now that health care activists are asking the LHIN to follow process that normally accompanies such restructuring, the changes have become cutbacks after all.

The reality is nobody knows what the impact of these cuts or restructuring or whatever-you-want-to-call-it will be.

The LHIN could require the hospital to come forward and present its plan. That plan should tell us where the services are being transferred to, what the cost will be, and how it will impact patient access.

You might call it health care planning.

Instead we have had a litany of excuses as to why such massive cuts to the hospital and potential privatization of services are not being treated in an orderly and transparent fashion.

Yesterday we learned of another LHIN that required repeat prompting by the local MPP before they would launch an investigation into a northern hospital that was generating considerable community concern.

Is this really how it’s supposed to work?

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Could the Wynne government do a u-turn on austerity?

Posted on March 13, 2013 | 1 comment

It didn’t get much coverage in the mainstream media, but last week the big banks told Federal Finance Minister Jim Flaherty to take his foot off the brake when it comes to public sector spending.

The banks argue with a weakening economy, now is not the time for restraint. That could mean pushing back Ottawa’s target to wipe out a $26 billion federal budget deficit by $5 billion per year.

“You won’t have many economists — or the bond market, which is perhaps a more critical vote — end up criticizing Canada if a couple of years down the road, instead of having a balanced budget, we have a $2 or $3 billion deficit,” CIBC chief economist Avery Shenfeld told the Toronto Star last week.

It’s a rare meeting of minds – the same message is being delivered by the Canadian Centre for Policy Alternatives, who argue economic growth is more important right now than the deficit.

Private sector economists are predicting economic growth in Canada will slow to 1.5 per cent for 2013.

If the economists left and right are telling Flaherty this, then Ontario’s Wynne government must be receiving the same message. This is important — if the provinces and the federal government are rowing in opposite directions, their initiatives would likely cancel each other out.

You can also bet that new Ontario finance Minister Charles Sousa – who emerged from the world of banking – is also listening to his former colleagues.

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If hospital cuts are restructuring, then let’s see the evidence

Posted on March 11, 2013 | Leave a comment

There is little question that a provincial freeze in base hospital operating funding is motivating the present shedding of staff positions and services across the province.

Hospitals are required to balance their budgets by law, but Local Health Integration Networks regularly extend exemptions conditional on the hospital following an improvement plan worked out between the LHIN and the hospital.

Hospital CEOs and LHIN officials are usually reluctant to admit that significant budget cuts will impact service delivery, even if the impact is obvious in examples where hundreds of staff positions are lost (ie. Peterborough Regional). That’s because significant changes in service delivery should be treated as an integration decision, a 60-day process that puts on the onus on the service provider(s) to make a case for change in delivery to the LHIN. That case usually includes evidence of community consultation.

With the latest round of hospital cuts the Health Minister and Premier are suggesting what is taking place is not belt tightening, but restructuring.

If that is the case, then why not have the LHINs treat these changes as integration decisions where all the facts are put on the table and the community is consulted?

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Integration process missing from new round of hospital cuts

Posted on March 7, 2013 | Leave a comment

Local Health Integration Networks were purportedly created to bring health care planning, integration, accountability, and funding closer to the 14 regions they serve. A key role for the LHINs was to engage their regional communities in this process. The Ministry of Health and Long Term Care was supposed to set the strategic directions, and the LHINs were supposed to operationalize them within the context of regional planning.

While the Health Minister has mused about further empowering the LHINs, recent signs suggest that perhaps the opposite is taking place.

The South Bruce Grey Health Centre is a case in point. Comprised of four small hospitals working under one umbrella, the Ministry of Health is not exempting SBGHC from implementation of the new funding formula. Small hospitals were supposed to be excluded from a funding system that was becoming far more reliant on volumes that rural communities could not possibly muster. By sharing resources, the four small rural hospitals that operate as SBGHC are over the budgetary threshold for exemption. SBGHC has an operating budget of $43 million – a pittance compared to some of Ontario’s billion dollar urban behemoths like The Ottawa Hospital or Hamilton Health Sciences.

SBGHC took their case to the South West LHIN and they agreed implementation of the formula on this hospital would be unfair. It would also throw SBGHC $700,000 further in debt next year if they failed to cut needed services. Continue reading →

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No community involvement, details needed when cutting or transferring services to balance a budget

Posted on February 13, 2013 | 2 comments

The Local Health Integration Networks were initially set up to involve communities in the decision-making process around delivery of regional health care.

We have witnessed health care providers, such as hospitals, coming forward to the LHINs with proposals to shift services, identifying how they engaged stakeholders in the planning process before coming forward with a plan for integration.

Recently we contacted the Champlain LHIN to ask if the same process is applying to the recently announced changes to service at The Ottawa Hospital, including the so-called “transfer” of endoscopies and cataract services to unidentified providers within the community.

Much to our surprise CEO Chantale LeClerc replied that no integration is triggered because the hospital was making these changes under the terms of its accountability agreement.

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News of failed private endoscopy clinic coincides with hospital’s intent to divest more endoscopies

Posted on February 6, 2013 | 1 comment

It shouldn’t have been a surprise to anyone in Ottawa.

When the College of Physicians and Surgeons of Ontario finally released the list of private clinics that failed their inspection, it included one Ottawa endoscopy clinic that was already the subject of a rare public warning in 2011. The 2011 warning suggested that patients of the private endoscopy clinic may have been exposed to HIV, hepatitis B, and hepatitis C as a result of equipment that may not have been properly sterilized.

After nearly 7,000 patients were asked to get tested, five were found to have contracted either hepatitis B or C. The five are part of a larger class action against the clinic, although connecting their disease to unsanitary equipment may be difficult to prove.

Given everyone knew the list of clinics that failed inspection would soon be made public, it is curious that Dr. Jack Kitts, CEO of The Ottawa Hospital, should suggest during the same week that he intended to divest 5,000 endoscopies a year from the hospital to private clinics. Perhaps unfairly, the question must have been none-the-less on everyone’s mind: divest to clinics like this?

An endoscope is a diagnostic procedure that inserts a camera inside the body with a flexible tube to look at internal organs.

This week’s disclosure by the College gives us a view of the clinic that goes well beyond the issue of improper sterilization.

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Ottawa and Hamilton: Significant hospital cuts ahead despite rhetoric from Premier-designate

Posted on February 4, 2013 | 3 comments

Dr. Jack Kitts, CEO of the Ottawa Hospital, says he plans to transfer about 5,000 endoscopies to community hospitals and clinics as part of an overall plan to find $31 million in savings towards balancing the hospital’s budget.

Kitts announced last week that 290 full-time equivalent positions would be eliminated at the hospital, including 90 positions in nursing, 100 in administration and support services, and a further 100 “other” health professionals. There is no word whether any senior managers will have to fall on their sword.

The impetus for the cuts are clear – The Ottawa Hospital is facing the long-term prospect of zero per cent annual change in the base funding while costs continue to rise with a growing and aging population. It has little to do with restructuring.

Divesting 5,000 endoscopies may save the Ottawa Hospital money, but it won’t necessarily save the provincial health budget as these costs get borne elsewhere. Then there’s the matter of The Ottawa Hospital facing direct costs related to severing employees. Kitts says it’s cheaper to do these endoscopies elsewhere, but he gives no evidence to back up his claims.

Calculating the human cost of such actions is always much more difficult. The Ottawa Hospital was subject to a major study in 2009 on role overload, suggesting workers at the hospital were already facing anxiety, fatigue, and burnout as a result of having to do too much with too little. For those left behind, the fear of having their workload become totally unmanageable is very real, raising questions about how safe the hospital will really be.

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Visible tattoos and piercings on hospital staff okay — arbitrator

Posted on January 21, 2013 | 1 comment

The Ottawa Hospital was attempting to fix a problem that didn’t exist when it unilaterally imposed a new dress code on employees according to a recent arbitration decision.

Most contentious was a requirement that workers at the hospital cover up large tattoos as well as prohibiting “visible, excessive body piercings.”

The Ottawa Hospital also stopped certain workers from wearing jeans and Bermuda shorts and insisted nurses wear lab coats in the hospital while off duty.

All of these restrictions were struck down in the January 14th decision following a 2010 policy grievance by CUPE Local 4000.

Arbitrator Lorne Slotnick stated in his ruling: “the employer’s argument is explicitly based on its willingness to accept and acquiesce to patients’ perceived prejudices and stereotypes about tattoos and piercings, even as it offers no evidence that these have any impact on health outcomes… The hospital could not and would not accede to the wishes of a patient who might be uncomfortable with a care provider based on the employee’s race or ethnic identity, even though some patients might harbour those types of prejudices.”

Slotnick said that no patient was being forced to “accept” tattoos, but instead were receiving care from many individuals who reflected the diversity expected in a big city.

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Are there more managers and fewer front line staff? At some hospitals, absolutely

Posted on September 26, 2012 | 3 comments

Earlier this year we issued a freedom of information request to 20 sample hospitals where OPSEU represents health care workers to understand whether managers are in fact replacing front line health care workers.

Nine of 20 hospitals reported an increase in managers proportionate to front line staff over the past five years.

It’s a frequent complaint we hear.

While the requests were sent out in February, the information took much of the year to trickle in.

Resources are getting ever tighter in the hospital world – Ontario hospitals are experiencing no increase in their base budgets this year. How hospitals allocate their funding does matter.

Some hospitals actually reduced managers – at Kingston General Hospital, for example, managers dropped from 146 in 2008 to 125 in 2012. Staff has remained almost exactly the same over the past five years at 2,453. Other hospitals that dropped managers include the Chatham Kent Health Alliance, South Grey Bruce Health Care and the Windsor Regional Hospital.

Others show that our members were right.

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