Tag Archives: The Ottawa Hospital

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

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?

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?

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

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

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

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

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

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

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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