Vera Tsotsos is a ward clerk at The Scarborough Hospital. After 19 years on the job she received notice in the spring that her full-time position would be eliminated. Her last day is today. “I would not recommend my job to my daughter or my granddaughter,” says Tsotsos, who sees the damage done by the constant insecurity her colleagues face.
While she could have likely moved into another opening at the hospital, she chose to leave instead. “I had enough,” Tsotsos told us.
Hospital support workers require considerable skill and training to do their jobs effectively. Yet they are often the first to be let go when money gets tight. Ontario hospitals are shedding jobs to balance years of zero-based funding from the provincial government. In the process, they are also sending years of valuable experience out the door.
It’s time that the OHA and the Ontario government come clean and reveal the real cost of their austerity agenda.
In the coming weeks we will be highlighting some “straight talk” from OPSEU’s hospital support workers that features the work they do and the challenges they face doing their best to serve the public. The first series of vignettes was shot at OPSEU’s annual convention in May.
When Charles Sousa unwraps his Ontario budget on Thursday there likely won’t be any new money for expanding hospital infrastructure.
Coming out of the Harris era, the McGuinty/Wynne government faced a considerable backlog of infrastructure needs, including updates to many Ontario hospitals.
To date there have been more than 100 major hospital infrastructure projects – or a project for two out of every three hospital corporations in the province. About a third of these projects have been costly long-term public-private partnerships where the private sector is responsible for the design, construction, financing and maintenance.
Paul Rosebush, CEO of the South Bruce Grey Health Centre told Bayshore Broadcasting that the economic forecast has raised some red flags that essentially mean that if you are not on the existing list for a rebuild, you won’t be.
In the end the price was too much.
The merger between the Scarborough and Rouge Valley hospitals appears to be sidelined after months of intense activity including unprecedented community consultation.
March 15 The Scarborough Hospital board passed a resolution that abandons the amalgamation “effective immediately,” although provides faint hope that the province will reconsider merger conditions set by the two hospitals, including funding for one-time costs.
Those costs are substantial – the two hospitals would be looking for about $30 million in one-time basic merger costs and an additional $5 million annually for salary adjustments. The province did ante up $3 million.
The two hospitals were also looking for more than $2 billion in new buildings to replace aging infrastructure and to double the size of the Ajax-Pickering hospital.
That’s a steep price when hospitals are likely to enter their fifth year with base funding either frozen or well below real costs. That funding restraint includes two years of zeros and counting.
The Rouge Valley Health System and The Scarborough Hospital officially filed notification to the Local Health Integration Network of their intent to merge, but it doesn’t mean hard times are over. Robert Biron, CEO of The Scarborough Hospital, sent a memo to staff Tuesday that reminded everyone that the health service provider still has a budget to balance. Biron estimates cost pressures of $8.4 million for 2014-15. The hospital has projected revenue increases of $1.6 million, but it still leaves them $6.8 million short. That shortfall represents about two per cent of TSH’s annual budget. Biron says it is the intention of the hospital to “minimize the impact” to services and staff positions where possible, however the memo gives notice that voluntary exit and early retirement packages will be offered soon. No specific cuts were identified in the memo. The TSH board will receive the budget plan on March 4th. Despite the formal notification to the LHIN, the hospitals will not make a final decision to merge for another 60 to 90 days.
In December we reported on a local fight-back campaign by the unionized staff (CUPE, OPSEU and ONA) at the Arnprior and District Memorial Hospital. The professional and support staff at the hospital are upset by the loss of six acute care beds at a time when the region’s population is rapidly expanding. Now our colleagues at CUPE have posted an on-line Avaaz petition for community members to sign that calls on the hospital to reopen the beds and staff them properly. If you’d like to add your name to the Avaaz petition, click here.
The Ontario College of Physicians and Surgeons has raised an interesting point around the province’s plan to shift endoscopies from hospitals to private Independent Health Facilities (IHFs). The College notes that IHFs are presently exempt from the Out of Hospital Premises Inspection Program (OHPIP) it conducts. Up until now endoscopy clinics have been considered community speciality clinics, not IHFs. In the most recent issue of the College’s Dialogue Newsletter, they state “the OHPIP model functions more efficiently and quickly to protect patients than the IHF model.” Despite the shift in status, the College is proposing to continue doing OHPIP inspections at these facilities. In 2011 the College warned that a private Ottawa endoscopy clinic failed to properly sterilize equipment and placed patients at risk of HIV, hepatitis B, and hepatitis C. The College also found that the clinic’s nurse was preoccupied with advancing the scope and not recording vital signs, that potential exposure to toxic fumes took place, single-use items were being re-used, and that cramped and cluttered premises posed a hazard by making it difficult to transfer a patient in the event of an emergency. Endoscopies and cataract surgery are at the top of the province’s list for divestment from community hospitals.
The more Ontarians understand the threat by PC leader Tim Hudak to end the Rand Formula, the less they like the Tories. While Forum Research president Dr. Lorne Bozinoff told the Toronto Star the anti-union policies are not seen as a massive wedge issue, “there’s some uneasiness that they’ve (PCs) just gone too far to the right.” The Forum Research Poll shows the Tories dropping in public opinion in tandem with declining disapproval of the Rand Formula. Those opposed to the Rand Formula dropped from 45 per cent to 38 per cent from November to January. Likely Ontarians are coming to understand that by undermining the province’s trade unions all labour rights are threatened – both union and non-union. The Forum Research polls still places the Tories in the lead at 36 per cent followed closely by the Liberals at 33 per cent and the NDP at 26 per cent. NDP Leader Andrea Horwath and Liberal Premier Kathleen Wynne share 40 per cent personal approval ratings while Hudak continues to lag behind with 21 per cent. In a press release issued yesterday, Bozinoff said “it appears Tim Hudak’s signature idea, ending compulsory union dues, is not a winner in Ontario, even among supporters of his own party.” The random sampling of public opinion was conducted among 1222 Ontarians 18 years of age and older between January 24-25.
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Tagged ACE, Advocacy Centre for the Elderly, Arnprior and District Hospital, Avaaz petition Arnprior hospital, College of Physicians and Surgeons, Dr. Lorne Bozinoff, Forum Research, Home First Policy, Jane Meadus, OHPIP, Private Endoscopy Clinics, The Scarborough Hospital
Robert Biron quietly came into the Central East LHIN board meeting and sat as a spectator. The CEO of the Scarborough Hospital silently left the room again after the LHIN gave him most of what he came for.
One of the conditions of a potential merger between The Scarborough Hospital and the Rouge Valley Health System was seed money towards a feasibility study for a new Scarborough mega-hospital to replace the three outdated sites – Birchmount, Scarborough General and Centenary – as well as an expansion of hospital services in West Durham.
The LHIN had no problem endorsing the “service and program elements” of the pre-capital submissions, but realized that any decision on West Durham would likely have to involve the other major regional hospital: Lakeridge Health.
After being spurned by Toronto East General and eventually finding a dance partner with the Rouge Valley Health System, the Scarborough Hospital may be a little bashful about turning even further East to take Lakeridge Health out on a date.
The LHIN stresses that any contact with Lakeridge would be about capacity planning and not integration. It’s purely platonic even if Lakeridge has a very lovely cancer centre and a recent history of balanced budgets.
The reasons behind the two capital plans are very different. The Scarborough General is an oddball warren of add-ons and their operating rooms are among the oldest in the province. The two hospitals also like to remind us over and over that Centenary is only six kilometers from the Scarborough General Hospital. The Ajax-Pickering Hospital (RVHS) recently completed a significant modern expansion, but the planning was never sufficient for the rapidly expanding community.
In a perfect world hospitals would be publicly funded to meet the health needs of their communities. That would be it.
When the government started talking about funding reform, the thinking was that at last we would be moving closer to a rational system of allocation.
What we got instead was a hybrid of global funding, competition, and a funding formula that was supposed to take into consideration both existing usage and local demographics. Layered on top is a base funding freeze to at least 2018. Money has always been a driver in the health system, but suddenly it appears to be driving everything.
The evidence suggests that the complex and confusing system of funding allocation is creating new inequities that may be even worse than the ad hoc system of the past.
The South Bruce Grey Health Centre, for example, has argued to the South West LHIN that they are being penalized for efficiently combining the resources of four small rural hospitals. The Scarborough Hospital and the Rouge Valley Health System have made it clear that the complex demographic needs of their two communities are not being recognized in their base funding allocation.
What the new funding system appears to be doing is driving a new wave of costly and disruptive hospital mergers. You can’t blame the hospitals for seeking such mergers because they are simply acknowledging the new rules of the game set by the province. In this new world bigger gets more clout gets more funding.
The merger of The Scarborough Hospital (TSH) with the Rouge Valley Health System (RVHS) will not come cheap. Last night the hospital boards approved the idea of merger but only under very specific and costly conditions.
Nor will the merger necessarily stem the tide of cuts The Scarborough Hospital has been experiencing. At last night’s special meeting of the TSH board, CEO Robert Biron was asked whether continuing cuts would be seen as a failure of the merger?
Biron said funding constraint is part of the government’s transformation agenda and that merged or not, the hospitals would have to navigate it anyway. He told the board that together they were more likely to minimize the impact of such restraint.
Given an estimated $29.5 million in one-time fixed costs around the merger plus a wage harmonization bill of $5.4 million, these costs are likely to be held up against the loss of any services the merged hospital decides to shed in the future. There is still resentment over the loss of $17 million worth of services earlier this year to balance TSH’s budget.
Tonight The Scarborough Hospital and Rouge Valley Health System are having their second public telephone town hall to discuss the benefits and risks of a merger.
The first town hall on September 24 attracted more than 8,000 participants.
The irony of this process is that it has provided incredible amounts of information but many have still come away feeling that they don’t have enough detail to make a decision to support or reject merger.
Scarborough CEO Robert Biron says there is no hidden agenda.
He is right. What we have are two large urban hospitals that are under similar pressures to 149 other hospital corporations in Ontario due to the province’s decision to freeze hospital funding at least until 2018.
Most, however, have decided not to examine formal merger to deal with the funding freeze as have these two hospitals.
If this were the private sector, you wouldn’t have the board of a $352 million organization sitting in such uncomfortable chairs.
Despite signs of modest economic recovery, it’s still hard times for many of Ontario’s hospitals, including The Scarborough Hospital. October 1st the TSH board met at the Birchmount Campus to conduct the hospital’s business.
Struggling financially – their line of credit recently increased to $30 million – the hospital is now facing an all-consuming discussion of merger with the somewhat healthier $326 million Rouge Valley Health System.
Maybe once they are a $678 million joint entity the chairs destined for board meetings will at least get better.
While engaged in an open and transparent process around the merger, there are clear signs that public engagement is not so much about gathering input to make a decision, but finding pockets of community opposition and trying to win them over to what appears to be a done deal. TSH CEO Robert Biron insists no decision has been made but continues to promote the benefits of merger.