Ontario Council of Hospital Unions/CUPE Defending healthcare in every community

Ontario Healthcare: News and Commentary by Doug Allan

If contracting out works, why do they keep suspending it?

Thu, May 17 2012 03:53 PM | onpoli, home care, cdnlab, cdnhealth | Permalink
The Ontario government's system of contracting out for home care services (the so-called "competitive bidding" system) has been put on hold for another two years, it seems. 

Following a meeting with government officials, various bosses and mucky-mucks in the Ontario home care industry have come out and  declared the following:  

As proposed in a first step in a phased transition, new contracts would be developed and then negotiated with existing service providers outside of a competitive bidding process, effective October 1st, 2012 for the subsequent two year period (2014). These new contracts would reflect the realities of our environment; quality imperatives, fiscal restraint, greater focus on client-centred care and defined client populations, and the requirement to collaborate and implement change over a short period of time.   In subsequent phases it is proposed that all home care contracts will be renewed based on clear performance metrics related to transition, quality improvement, client satisfaction, innovation and value for money. Opportunities for new entrants to obtain contracts would be provided through joint ventures, subcontracts or other arrangements.

They claim “the Ministry looks forward to receiving a proposed plan from the sector for moving forward in order to establish new service contracts by October 2012.”   

This is just the latest suspension of compulsory contracting.  In the face of community opposition, the government has been forced to suspend the process for years.  They tried to bring it back under Health Minister Smitherman in 2007, but that quickly blew up in his face.  

If you can believe the home care bosses, this time around they are trying to stop providers losing contracts and limit new entrants to the industry even after October 2014.  

The good news is that this may provide a bit more stability to an industry that, for decades, was supposed to be the cornerstone of government reform, but was actually being restructured back to the stone age.   

The bad news is that this will cement the role of for-profit providers  -- who took most of the work away from not-for-profit community providers after compulsory contracting was introduced by the Mike Harris government.  

The government plans to introduce a similar contracting system for surgeries and other health care services.  Health care privatization really is like the zombies:  they may take a blast to the head but they still keep getting up. 
Doug Allan
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Ottawa Hospital privatization: 314 jobs brought back

Wed, May 16 2012 01:00 PM | privatization, Ottawa | Permalink
For the last ten years, the Ottawa Hospital had contracted out housekeeping at its General site to a large, foreign-based corporation.  But as of May 13, those 314 housekeeping staff were brought back to work as employees of the Hospital.

CUPE has long raised concerns about the effects of the privatization of housekeeping.  Apparently, hospitals can rethink even long term privatization initiatives.  Congratulations to CUPE Local 4000.   
Doug Allan
Comments (2)

P3 projects slow to a trickle

Sun, May 13 2012 09:00 PM | Britain, p3s | Permalink
Six months after repeated disasters forced the British government to review its policy to develop infrastructure via public private partnerships (P3s), the number of new P3 projects has fallen dramatically.  The Financial Times reports that 85% fewer P3 projects were agreed to in the first four months of 2012 compared with one year earlier.

The construction industry is not pleased: The head of the UK Contractors Group (comprised of 30 big contracting firms) said the government needed to make “clear decisions soon...I don’t know if the government is going to tweak the model or do something more radical. But it would be good to have a clear signal from government as to where they are going with it.”

The head of infrastructure at KPMG,  told the Financial Times “The industry is being crushed between the loss of commercial activity and the government turning off the tap on its own spending. It needs projects now."


P3 corporations made very big profits for many years from the public purse -- while jobs were privatized  and public services cut.  So it's hard to shed too many tears for their current predicament.  

Doug Allan
Comments

Cuts at the Ottawa Hospital: Almost 100 jobs to go

Sat, May 12 2012 05:26 PM | Ottawa, cutbacks, onpoli | Permalink
The Ontario government's squeeze of hospital funding announced in the March provincial Budget is hitting home.  


Yesterday, the Ottawa Hospital told the media that almost 100 positions will be cut as a result of the hospital's $23 million deficit (on a $1 billion budget).   No formal announcement from the Hospital is on their web site today.


Reportedly, over sixty positions will be cut in from the Hospital's office workers, mostly in medical records. 


The hospital claims the cuts will mean no cuts in service.  


Right.  Unfortunately, these days, that is the usual theme hospital administrators repeat  -- as they implement cuts.  (I'm betting the government is quite pleased with that line.)


The Ottawa Citizen reports the Ottawa Hospital remains unsure about its financial situation since the Liberal government has delayed telling Ontario hospitals how much funding they will receive in 2012-3.  The Citizen reports that under a best case scenario, the Hospital will get an additional 0.6% funding this year.  




Doug Allan
Comments

48,100 public sector jobs eviscerated in one year

Fri, May 11 2012 12:20 PM | unions, economy | Permalink
Ontario unemployment increased last month from 7.4% to 7.8%.  While employment grew in Canada as a whole, it fell slightly in Ontario, decreasing from 6.788 million jobs to 6.781 million jobs.

Across Canada, there was a sharp decline in the number of public sector workers, with a loss of 19,200 public sector jobs in one month. In Ontario, the declines were in both the public and private sectors, with 1,100 job losses in the public sector and 9,300 in the private sector (there were modest gains in 'self-employment' reducing the total loss).  Notably, however, while there has been growth in private sector jobs over the last year in Ontario, there  has seen a steep decline in the Ontario public sector, with 48,100 public sector job losses in one year.

That means there has been a loss of 3.5% of all public sector jobs in Ontario in one year.  In fact April 2011 was the all-time high for public sector employment in Ontario.  Before that there were some increases in public sector employment, with a total of 65,700 jobs gained between April 2008 and April 2011, roughly comparable with population growth.

Government austerity has led to deepening economic problems in Europe.  Ontario is "leading" the way with austerity in Canada. So far, the economic results for working people are unimpressive, with high unemployment, declining real wages, and declining public services.  On the other hand, corporate profits have been up sharply in Ontario...


Ontario
March 2012
April 2012
March to
Apr 2012
April 2011 to
April 2012
March to
April 2012
% change
April 2011
to April 2012
% change
Population
11,027.1
11,041.9
14.8
147.1
0.1
1.4
Labour force
7,329.6
7,354.8
25.2
33.3
0.3
0.5
Employment
6,788.2
6,780.5
-7.7
37.5
-0.1
0.6
Full-time
5,484.2
5,507.3
23.1
43.5
0.4
0.8
Part-time
1,304.0
1,273.2
-30.8
-6.0
-2.4
-0.5
Unemployment
541.5
574.3
32.8
-4.2
6.1
-0.7
Participation rate
66.5
66.6
0.1
-0.6
...
...
Unemployment rate
7.4
7.8
0.4
-0.1
...
...
Employment rate
61.6
61.4
-0.2
-0.5
...
...



Ontario
2011
2012
2012
2012
April
February
March
April
Public sector employees
1,362.0
1,319.8
1,315.0
1,313.9
Private sector employees
4,351.0
4,380.0
4,434.1
4,424.8







Note: Numbers are reported in the thousands.


Doug Allan
Comments

911 "beat the queue calls" -- Emergency Room backups

Wed, May 9 2012 03:55 PM | Waterloo, ERs, EMS | Permalink
With long line-ups at hospital Emergency Rooms, people are beginning to call ambulances to take them to the ER, hoping the ambulance and paramedics will speed them through the ER.   "We call them beat-the-queue calls," John Prno, regional director of emergency medical services reported.



Paramedics have to stay with the patient until they are seen by hospital staff, which reduces ambulance availability, the Waterloo Record reports, creating offload delays where paramedics must wait in the hospital rather than save other patients in the community.  

Offload delays at Waterloo hospitals increased by 20 per cent in 2011 for a total of 6,990 hours, the equivalent of an ambulance parked 24 hours a day for 291 days.


The good news? The number of Code Reds, where no local ambulances are available for an emergency call, dropped to 12 per month from an average of one a day in 2010. The EMS director noted that the hiring of five paramedics last year and another five on July 1 should help.



Doug Allan
Comments

Sudbury hospital back-up gets worse

Tue, May 8 2012 12:31 PM | Sudbury, ALC | Permalink
Now there are 96 hospital ALC patients at the Ramsey Lake site of Health Services North. Thats up from 77, as reported April 17.

The Hospital closed 30 beds for ALC patients at its old Memorial site in March.  Since then the number of ALC patients at the main site (Ramsey Lake) have ballooned.  The Sudbury Star reports that the number of ALC patients has increased from 40 or 50  in January. The beds at the Ramsey Lake site are not intended for ALC patients and are more costly to operate.

With the back up in beds, ER wait times are increasing.  Another 30 ALC beds in Sudbury are scheduled to be closed next March as well.


Doug Allan
Comments

Perth-Smith Falls Hospital cancels surgeries as ERs back up

Mon, May 7 2012 07:35 PM | cutbacks, Perth, ALC | Permalink
The Ontario government reports that it is focused on moving patients out of hospitals -- and into the community.  But this is not going well at the Perth Smith Falls District Hospital.

The Hospital has designated thirty percent of its patients as "ALC" -- that is, it wants them out. But government organizations charged with this responsibility (the CCAC and LHIN) have not been able to achieve this so far.  

The result? On one day recently there were 16 patients awaiting admission from the Emergency Departments. Further, some patients who were scheduled for elective surgery unfortunately had their surgeries cancelled and rescheduled due to a lack of available beds.
Doug Allan
Comments

Home care: two tier wages introduced in Hamilton

Tue, May 1 2012 11:47 AM | unions, onpoli, Hamilton | Permalink
St. Joseph's Home Care in Hamilton (part of the same outfit that runs St Joseph's Hospital in Hamilton) is  imposing two tier wages on home care workers.   For new home care contracts, Personal Support Workers (PSWs) will earn about 15% less, the Hamilton Spectator reports. 


The Spectator expects a new home care system to be introduced in the fall. St. Joseph's believes the new wages will "position" the organization for a wave of new home care contracts.   (The current system of compulsory contracting has been under suspension in Ontario for years  -- after multiple failures).


St. Joseph's Home Care boss, Kim Ciavarella claims “In the old contracts, we were bidding to be the lowest bidder. That's our decade past. I really see a fundamental shift coming.”


In fact in the old  compulsory contracting system, the government also claimed that it wasn't about being the lowest bidder.  Despite abundant evidence to the contrary, 'quality,' they kept saying, was paramount.    


Now and then, however, one result seems constant:  the workers get ....


Doug Allan
Comments

LHINs get stuck with even less funding

Wed, Apr 25 2012 09:25 AM | funding, LHINs | Permalink

The Local Health Integration Networks (LHINs) are getting stuck again.  

According to the newly released Budget Estimates, the government is cutting their funding.  The cut is, at least, small ($3.25 million out of a total LHIN funding of $23 billion). LHINs are the primary funders of hospitals, long term care homes, and home care. 


Last year, at least they got a little bit of an increase -- 0.9% (based on the scope of services the LHINs are currently supposed to cover).  That gives the LHINs a whopping $64 million extra to play with compared with two years ago.  That might sound like something until you consider they provide $23 billion in services.  

In effect, the government is making the LHINs the bad news bearers.  With no new money, they are going to have to squeeze the providers.  Health care consultants who dreamed that LHINs would become powerful agents for change will be disappointed.  At most, the LHINs will have to suffice with encouraging change through a lack of money. 

The government, in contrast, is allowing itself the right to make new funding announcements via new Provincial Program  funding. 

As in recent years, almost all the new health care funding is going not to the LHINs but to the line item described as  “Provincial Programs and Stewardship”.   The Provincial Programs and Stewardship  line will get $0.932 billion in new funding (out of a total of $1.012 billion new health care funding).  That’s 92% of the new health care operating funding.  

This isn't new -- the government has been starving the LHINs for years while increasing their own "Provincial Program" funding, especially the vaguely named "Community and Priority Program" sub-line item.  (Although there is at least one part of the new Provincial Programs funding that is fairly specific – the promised $125 million for home renovation tax credits.)   

The total health care operating expense increase for 2012-13 is 2.17%.  The total capital and operating expense increase is 1.9% (notably less than the 2.3% suggested in the Budget at table 2.29) .
Doug Allan
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