Ontario Healthcare: News and Commentary by Doug Allan

Rural hospital should be a hub for health care. Barry's Bay clinic shines a light

While the McGuinty government is trying just about everything (short of bricking up the front doors) to stop health care from happening in hospitals, St. Francis Memorial Hospital in Barry's Bay is trying out a very interesting experiment that is expanding the range of local services available through the hospital.

Instead of the usual attempts to close down hospital clinics, the hospital has opened a Community Care Access Centre (CCAC) nursing clinic.  The CCAC used to sponsor a health clinic, but although it was located right next door to the hospital, red tape and bureaucratic obstacles ate up hours of time for patients, doctors and nurses if any referrals were necessary.  The clinic closed in February, unable to sustain itself on low patient volumes.

The pilot project in the hospital was launched on June 28 and is scheduled to wrap up on Sep. 12. Reportedly there will then be talks between the CCAC, the hospital, and the Champlain Local Health Integration Network (LHIN) to determine whether the project is continued.

"I think it's the first step to many opportunities to look at how, on the rural side, the hospital with all its resources, its history, its culture could be the one providing more care in the community" says the hospital Chief Operating Officer, Jeremy Stevenson.

"We're providing some local care, right here in our community, people seen within a few minutes, and any time of the day versus in the past when you had to come in within those four hours. We can provide the service the whole day. It's just phenomenal."

Indeed, this does sound good.  
Given the push by the McGunty government to shrink the scope of hospital services (and especially shrink small town hospital services),  the future of local hospitals in smaller communities depends on them becoming hubs for a wide variety of health services. That integration will keep them vital and able to attract doctors and other health care staff.

A goofy idea goes down. The Liberals (and the LHIN) retreat.

As reported here a week and a half ago, the Erie St. Clair Local Health Integration Network (LHIN --  the guys charged with funding and restructuring Ontario health care) was planning to bring in Disney speakers for an hour or two at an upcoming LHIN conference. 

Well (following a lot of public criticism), it now appears that even the LHIN finds this idea too goofy (or, perhaps, just a little mickey mouse).  So they've pulled the Disney speakers. 

But the Erie St. Clair LHIN CEO, Gary Switzer, is not backing down graciously.  Here's his response to Tory leader,Tim Hudak, who had criticised the plan:  “Let’s be very clear — this guy is making this crap up and it’s false. I don’t think the public is stupid enough to believe him.”

The Windsor Star notes that Switzer countered Hudak, claiming the LHIN was not going to spend $10,900 for Disney speakers to lead the 90 minute chat, but rather only $9,500.

(At this point I might note that I'd be more than willing to talk all day for $9,500 dollars -- and I have actually worked, a little bit, on Ontario health care.)

Interestingly, the Toronto Star reports that the government called the LHIN last week telling them to scrap the idea, with a follow-up call on Tuesday.  Switzer, the LHIN CEO, says a “team decision” was made to cancel the Disney contract late Tuesday or early Wednesday.

That, I think, is a pretty good indication of the true independence of the LHINs from the Liberal government.

By the way, the two speakers still on the LHIN conference agenda are Michael Decter, a former Deputy Minister of Health and LTC and Saad Rafi, the current Deputy Minister of Health and LTC. Decter is a dedicated advocate of the failed experiment with competitive bidding in home care in Ontario, while Rafi has long advocated privatized P3 hospitals.

Finally, the Erie St. Clair LHIN has just contracted out an overall review of the five hospitals in the LHIN to the private consulting firm Deloitte. (Who will take a cool $1.5 million from the LHIN for their trouble.  Switzer says the review is beyond the resources of the LHIN itself.  Despte the 'e-health' fiasco, the  fascination with contracting out continues, apparently.)  The Deloitte review is supposed to be completed  in  December.

I'm expecting more goofy ideas.   With at least a few from Cruella Da Ville.


"Bob Chiarelli get off your butt and help us fight these hospital cuts!"

Yesterday about 200 people joined a rally called by OCHU and CUPE Local 2875 at Queensway Carleton Hospital in Ottawa to protest bed cuts. Queensway Carleton employees were joined by hospital workers from Cornwall, Brockville, and other points in eastern Ontario. Local 1974 at Kingston General chartered a bus. A few workers even came from OCHU Area 4. And it was a very pleasant protest.

Local 2875 President Ian Rayment called on local Liberal MPP Bob Chiarelli to come through and help the Local union stop the cuts.

The chant of the day? I nominate: "Bob Chiarelli get off your butt and help us fight these hospital cuts".  Local 2875 met with him a few months ago, to little avail. But Chiarelli has just been elevated to cabinet -- so he should have more ability to deliver now. We will see.

In the past, most hospital protests were in smaller cities, so this is something new. On September 2, a protest at Providence Healthcare (in Scarborough) brings the protests to Toronto.


Port Colborne considers legal challenge of Ontario hospital emergency room closure.

The City of Port Colborne passed a motion Monday night to seek legal advice on legal actions it might take  regarding the shutdown of the local hospital's emergency room, the Tribune reports.

"We have made the move to seek that legal advice and take the appropriate steps," said Mayor Vance Badawey.  Barbara Butters, a councillor for Ward 4 in Port Colbourne was even franker:  "Do whatever it takes to make sure these charges get laid because there's no way those SOBs should be getting away with this," Butters said as citizens cheered from the public gallery.

 Municipalities are playing are bigger role defending local hospital services. Good on them!

Wage freeze rationale fizzles as Ontario deficit shrinks (retroactively)

Of the provincial deficit and Dwight Duncan, the provincial Finance Minister, the Toronto Star suggests that the “spectre of looming shortfalls … helps bolster Duncan’s case for a planned wage freeze for more than 1 million public servants, including nurses, teachers and bureaucrats.”

Well, that argument is weakening.

The Public Accounts for the province have now come out for 2009-10 and the deficit is a lot smaller than Finance Minister Dwight Duncan and the Liberal government forecast. In fact, another $2 billion was lopped off the provincial deficit.

The Liberal government also reduced its deficit estimated by $3.4 billion the day before the March provincial budget. That makes the 2009-10 deficit $5.4 billion less than the Liberals had estimated it to be half way through the year.

(When I see discrepancies this size, it does make me wonder if I've put too much faith in Finance Ministry forecasts.)

In any case, the government will not get one-tenth of $5.4 billion through its proposed public sector compensation freeze this year. Indeed, they won’t get one tenth of the $2 billion figure.

One might think that this good news on the deficit might cause the government to reconsider the wage freeze.

But, alas, there is not much sign of that, yet.

While there is not much of an economic case for attacking public sector workers, the Liberals appear to think there are some political gains to be made -- apparently, it is all to harvest a few votes from Tim Hudak and the Progressive Conservatives.

Our job is to give them reason to review that (rather cynical) political calculation.  Without any pressing economic necessity,  a little political pressure might just tip the balance. 

Are the Liberals, for example, willing to introduce legislation and attack free collective bargaining to get their compensation freeze? It's not clear, especially if the Liberals are squeezed.

One thing's for sure: that plan didn't help Bob Rae too much when he was premier. He burnt his bridges with much of the labour movement when he attacked free collective bargaining in the public sector.  And that was when the deficit was a much larger percentage of the economy and the economic rationale a bit more credible.

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Pressure works: Health Minister finds the cash for beds in Kitchener

Following the political storm over the fumbled restructuring of mental health hospital beds in Kitchener, London and Cambridge (reported here earlier), the Minister of Health and LTC, Deb Matthews, has found some cash for hospital beds in Kitchener. 

But befitting our model of transparency, the Health Minister can't say how much money is promised, according to the London Free Press

Murkier and murkier.  Hospital funding is getting less transparent  -- and more political. 

It's the squeaky wheel that gets the grease. So my advice to local communities is -- squeak on.


Ontario cutbacks and wage freeze -- But even the WSJ has its doubts as Greece goes down for the count

Greece is likely the leading test case for public sector austerity, a policy which is beginning to sweep into other countries, and even our own Ontario, with its bed cuts and public sector wage freeze.

So it's interesting to see that even the not so labour-friendly folk at the Wall Street Journal are beginning to express some misgivings.  Here's the lead from their recent story on Greece's growing economic woes:

Greece's deepening recession is driving joblessness steadily higher, feeding discontent with the government's austerity program and dragging on the broader economy.   Greece's gross domestic product contracted by 3.5% in the second quarter from a year earlier, hitting retailers hard and sending unemployment rates to above 12% of the work force, according to data released last week.  Forecasts vary on how bad unemployment could get. The International Monetary Fund predicts the jobless rate will reach 14.8% by 2012. But some labor experts fear that before long, one in five Greek workers could be without jobs.

And, lo and behold, the WSJ almost admits that working people are bearing the brunt of the cuts:

Thanasis Alexopoulos has been relying on his parents for support since leaving university with a degree in German literature two years ago. The 24-year-old from Athens has spent a few stints waiting tables, but mostly has been sending out résumés without success. "I am seriously thinking of leaving Greece, because we need a revolution in this country to have hopes for a better future," he said.   Public-sector workers also are taking the brunt of job losses, as national and local governments pare back to meet stiff austerity targets. George Kiolias, 39, was queued up outside an unemployment office after losing his job—at the unemployment office. Mr. Kiolias used to work at the Athens central headquarters of the Employment and Labor Agency until he was laid off seven months ago.

Prediction:  Working people will also be the main victims of Ontario austerity measures. See here for the full WSJ article.


Ontario municipalities press government on bed shortages as Liberal MPP takes the heat

The Cornwall Standard Freeholder reports that the Association of Municipalities of Ontario (AMO) has established at its annual conference a committee with representatives of municipalities from all over Ontario to deal with the shortage of beds for long-term health care patients and lobby the provincial government for help.  (This sounds connected to some work by municipalities at the AMO conference reported earlier.)

Cornwall mayor Bob Kilger said the AMO is putting a document together to incorporate feedback from municipalities all across the province with similar problems. Then the committee will meet with stakeholders, such as hospital officials and government representatives. Councillor Sid Gardiner added the committee should make  progress as it puts pressure on the provincial government with the weight of 90% of Ontario municipalities.

Meanwhile the cuts continue.  After the closure of the adult diabetes clinic at the Northumberland Hills Hospital (NHH) earlier this year, now we get word that the monthly children's diabetes clinic run by the Peterborough Regional Health Centre at the NHH  is being closed.  Patients will have to travel to Peterborough now (if they can). 

When asked about the specialized clinic's loss from the local hospital, the NHH CEO replied that the "NHH has not been informed of any changes to this clinic."

The government's master plan for 'integration' and 'seemless care' might need a little more fine tuning. Especially as the government makes a big deal of bragging about the virtues of its 'Ontario Diabetes Strategy'.   (If this is how they deal with priorities...)

So it's not so surprising that not everyone is pleased with the government's health care performance in Northumberland.  Here's a blistering letter from one person concerning the performance of local Liberal MPP Lou Rinaldi:

Mr. Rinaldi, the LHINs and Ontario's Ombudsman
Northumberland Today; Thu Aug 19 2010; Page: 4; Letter to the Editor

At all costs, the premier and the Liberal party want to hold the riding of Northumberland- Quinte West. Their problem is that they have done major damage to the Northumberland Hills Hospital through the overbearing and secretive operation of a Local Health Integration Network (LHIN) which they created.

The government sees no way of finding the money to rescue our essential services, but they do think it possible to rescue Mr. Lou Rinaldi. So it is that we have a feel-good announcement concerning emergency services at the hospital. It is an attempt to buy back on the cheap the affections of an otherwise outraged electorate.

The Ombudsman of Ontario has just released a report on the behaviour of LHINs in the Niagara region, describing secret meetings dubbed "education sessions" for its members as "illegal" and suggesting that the same practice is found in all other LHINs. There can be no doubt that the LHIN in our region has failed utterly in its duty to be transparent and responsive to the community.

The LHINs exist to give political cover to a government that will not properly fund our health care. The Ombudsman observes: "Unfortunately, while it is true that as a result of the LHIN model, the Ministry of Health and Long-Term Care has been able to distance itself from difficult decisions surrounding the integration and funding of regional health services, the reality of community decision making has fallen far short of the political spin."

An expert at political spin, Mr. Rinaldi has remained somewhere above or below the fray as many of his constituents have sought to preserve their hospital. It is time for him to admit that the system of LHINs is a pernicious failure. If the premier will not hear his protest, he should leave the caucus. If he is unwilling to make such a protest, he should leave politics altogether.

Richard Greene Cobourg

Now this should help up the pressure to maintain local services.  Two thumbs up for Mr. Greene!


Wage freeze consultations dawdle as Liberals fall to second place

The first two weeks of the Liberal government's consultations with unions on a 'compensation freeze' are up. 

University faculty unions were one of the groups involved in the first two weeks of consultations. So here's the resolution on those consultations from the university faculty unions, passed on to the government Wednesday evening:

The Ontario faculty associations and other groups representing academic staff have received reports from their delegation about the issues discussed the week of August 9, 2010 with COU (Council of Ontario Universities) and government officials. We are confident that these issues can better be addressed at the local level by free collective bargaining. This would acknowledge the diversity of Ontario’s universities and their respective financial situations. We also do not accept the government’s premise that compensation is the cause of the current financial situation, nor its determination, made even before commencing its consultation process, that a two year wage freeze singling out public sector employees is the only way to deal with the province’s fiscal situation.

Accordingly, the faculty unions advised the government and the COU  that their "representative group...would no longer take part in the consultations."

OPSEU also reports that almost 100 people showed up to protest at a Liberal fundraiser at 6:30 Wednesday morning at a golf  club outside of Ottawa.  Members from CUPE, the CAW, PSAC, ONA , and the Ottawa and District Labour Council joined the protest.  The trade unionists handed out OPSEU golf balls to the attendees as they stopped cars attempting to enter.  Apparently some attendees grew impatient in traffic line-ups, with two incidents of aggressive behaviour resulting in police intervention.

Added to these woes, today's Ipsos - Reid poll shows that the Liberals have fallen to second place in the polls.  The Ontario PCs (whose loudest campaign of late has been for the abolition of McGuinty's health care LHINs) are now on top. The provincial election is a little over a year away, and no doubt with each passing week, the Liberals will become more sensitive to such news.

The formal compensation freeze consultations now break for a week.  OCHU/CUPE will confer with the government and the Ontario Hospital Association in the second round of consultations, starting August 30.


Wage freeze anyone? Ontario cost of living rises 2.9% -- Thanks Dalton McGuinty!

Buried in today's Statistics Canada report on inflation in July is the fact that inflation in Ontario has increased from 1.6% to 2.9%.   The new "Harmonized Sales Tax" (HST) came into effect on July 1 in Ontario.  As the HST transfers costs to consumers,  the increase in the cost of living in Ontario is now the highest in the land. 

This means you have to earn 2.9% more dollars to maintain your standard of living as of a year ago.  And if your wages were frozen (as the government would like), your standard of living would go down by an equivalent amount.

 For those of you lucky enough to live in Toronto or Ottawa, the increase is 3.1% and 3.0% respectively. (The Statistics Canada report is here and a quick Canada-wide summary from the Globe and Mail is here ).

It's worth remembering that the same McGuinty government that brought you the HST also wants to freeze your wages.

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