Saturday, November 15, 2008

Liberals force state-run health-monopoly cuts throughout Ontario

Looking for more evidence (see also: Second-rate Liberal health-care in Sudbury, Jim Bradley's hometown) of Dalton McGuinty’s mismanagement of his Liberal-run health monopoly?

Let’s look north from St. Catharines, across Lake Ontario, towards Belleville, and examine three recent articles, again, with eerily similar situations to those that St. Catharines and Niagara are also experiencing:

Michelle Newlands wrote in “Hospital struggles to solve $8 million deficit” (Loyalist college Pioneer, Nov.14, 2008):

“As the clock ticks, the deadline gets closer for Quinte Health Care to come up with a solution to an $8 million deficit problem.

The province has given QHC until March 31, 2010 to permanently eliminate $8 million from its annual budget, which means there will be significant cuts to services, according to Susan Rowe, manager of public affairs and community relations for QHC.

She says it is too soon to speculate about possible staff cuts as they are nowhere near saying what the impact will be on individual sites.

Rowe says once this reduction in the budget is implemented, QHC must continue to balance the new budget every year or else QHC will become a provincially-owned unit, like Kingston General Hospital, making this budget shortfall more than just a one-time issue.

The easiest way to understand why QHC is in this position, Rowe says, is to realize that in the past five years, expenses have gone up at a seven to eight per cent rate compared to a two to three per cent revenue increase from the Ministry of Health and Long Term Care.

Rowe says this is not sustainable and is a very complex problem that has been continuously evolving over time and QHC must now look at other options.“The board of directors and the management team feel they have now hit a wall and we can no longer take inefficiency out or find new revenue sources or any other way to balance the budget without looking at significant service cuts and consolidations.”

Wages, benefits, medication and information technology are all expenses that contribute to the overall increase of doing business, Rowe says. All these costs are continuing to rise, some of them at greater than inflation, and certainly at a rate greater than the two to three per cent from the Ministry.

The fact that Quinte has a growing population is also a main contributing factor to the problem of cost, Rowe says. The aging population and the fact there is such a high number of patients waiting for beds in nursing homes is directly related to the overall occupancy rate. The Ministry of Health typically budgets a hospital at an 85 per cent occupancy rate, where QHC is currently at a 100 per cent occupancy. Rowe says from a budgeting perspective, that 15 per cent difference is huge.

“There is no hospital in Ontario that gets paid per patient,” Rowe says.“We get a base amount and it doesn’t matter how many patients come through our door in any given year, that is the amount we receive.”

Julie Gunter, a second-year registered practical nurse, says the removal of any of QHC services is going to negatively affect health care because patients may not be offered the proper level of care. However, she does not yet feel her profession is at jeopardy because there will always be a demand for nurses with the aging population.

“They will always need RPNs [in health care] because we do hands on care with the patients and are [typically] more affordable [than other health care technicians],” she says.

Gunter believes none of the services offered through QHC should be cut because the health center is already struggling to provide the best quality of care to the community but she understands it is now out of their control. She trusts the management at QHC to consider all options and make a conscious and well-educated decision on how best to deal with the deficit.
The management team will be creating options that will soon be presented to the board. Once the board has decided on a possible course of action, there will be consultations with the staff, physicians, other health care partners and the public to come up with a final decision to implement the plan.

Rowe says this is a situation that is not unique to QHC; all hospitals across the province and even across the country are facing similar issues with overcrowding, financial shortages and shortages of health care professionals.”

In the above article, you might as well just replace “QHC” with “NHS” – the problems are the same!

Liberal monopoly health-systems are being ordered to CUT SERVICES and REDUCE BUDGETS in order to meet Liberal-created, artificial deficit envelopes.

When Newland reports: “The aging population and the fact there is such a high number of patients waiting for beds in nursing homes is directly related to the overall occupancy rate. The Ministry of Health typically budgets a hospital at an 85 per cent occupancy rate, where QHC is currently at a 100 per cent occupancy,” this sounds just like in St. Catharines!

When Rowe says: “We get a base amount and it doesn’t matter how many patients come through our door in any given year, that is the amount we receive,” – we should ask, is that also what happened in St. Catharines, prior to the Nov.29, 2007 CIHI discovery showing the St. Catharines General Hospital had the third-highest patient death-rate in Canada? Were the Liberals handing an aging and rising population a fixed amount of dollars to be rationed on a declining per-patient basis??

This apparently is the “status-quo”, the standard-operating-procedure norm in McGuinty’s authoritarian health-monopoly: under-funding their own system, while concurrently - and purposefully, by law - denying patient-hostages the option to obtain competitive payer/provider health care. This is demogogic Liberal ideology run amok; this kind of Tommy-Douglas-socialism-taken-to-the-extreme horror story should be considered nothing short of criminal.

Secretive St. Catharines Liberal MPP Jim Bradley has still not explained what led up to the high mortality-rate in the hospital in his own backyard. Yet, Ontario Liberals baldly claim that they ARE NOT (!) underfunding hospitals; they claim there is no link between the death-rate and their funding formula, but, they also refuse to allow the ombudsman to investigate their health monopoly.

MPP Jim Bradley didn’t even bother to call for any investigation into the Niagara Health System (NHS) after the high mortality-rate was revealed.

What Niagarans got were consolidations by the NHS, after a drawn-out ‘review’ (the Jack Kitts report of Oct. 2008) which only rubber-stamped the Liberal's grand plans of 'fixing health care by cutting health care', and, at the same time, preventing Ontario's patient-hostages from seeking their own, non-state-supplied health-care.


Barry Ellsworth wrote in “Hospitals face tough decisions” (Belleville Intelligencer, Nov.14, 2008):

" More than half Ontario's 157 hospitals have projected deficits for the end of the 2009-10 fiscal year and the trick will be to "minimize harm" to the health-care system as cuts are made, says Tom Closson.

The president of the Ontario Hospital Association said Thursday that due to several factors -- but most importantly the economic downturn -- hospitals are going to have to cut and consolidate services.

"It is a challenging time for health care at the moment because of the (economic) situation," Closson said.

Quinte Health Care will have an accumulated projected deficit of about $15.3-million by March 31, 2010.

Part of that can be laid at the feet of capacity -- its sites, particularly Belleville, Trenton and Picton, have beds taken up by so-called alternate level of care patients. Those are patients who are ready for discharge from hospital but have nowhere to go because of a lack of available nursing home beds and in-home nursing services.

Closson said that at any given time 30 per cent of beds are taken at QHC by these patients (the figure fluctuates), whereas the provincial average is 20 per cent. The situation has forced QHC to pay nurses overtime and stress on nurses has resulted in more sick time, driving up costs.

Nursing homes and in-home services would be cheaper and a more efficient use of scarce health-care dollars than keeping them in hospital.

"We could use the money more wisely," Closson said.

The province's 14 Local Health Integration Networks, which took over responsibility for health-care funding from the Ministry of Health, are working with the OHA to see what can be done to help hospitals secure balanced budgets, he said.

"We are doing a review of each hospital at the moment," Closson said.

Also causing financial grief is funding levels, he said.

Hospitals received an across-the- board increase of 2.4 per cent for 2008-09, and expect a 2.1 per cent in 2009-10.

"Inflation is obviously higher than that," Closson said.

But the big question mark remains the economic downturn that has struck the province, he said. It could mean funding levels to hospitals will be reduced even further.

"We don't know the answer to that (yet)," Closson said.”

Again, eerily similar to Niagara - Liberal MPP’s either don’t know what their own government is doing about the funding levels, or aren’t giving the answers – and they're the ones running the health monopoly.

Half of Ontario's 157 hospitals are in deficit, yet Liberals claim their underfunding has nothing to do with that?

What a load of Liberal Healthcare Duplicity.

Let’s not forget that Niagara’s so-called “review” process slowly began late in 2007, before the excuse of the “economic downturn” was taken seriously by the Liberals in the first place.

The Liberals were already underfunding their health monopoly prior to this excuse being used.

Again, the bed shortage/underfunding link is made by Closson (above), a link the Liberals keep denying. Dalton McGuinty himself ignored doctor’s calls to ease ER backups by creating more hospital beds. (St. Catharines Standard, Sept.30, 2006)

That was over two years ago: this statist assault on health-care by monopolist Liberals has been deliberate.

As detailed in the next article (below) the Quinte Health Centre is now also looking for a “reviewer”.
How coincidental … Dr. Jack Kitts just finished up the Liberal’s dog-and-pony show here in St. Catharines for the NHS, sooo ... maybe he's available?

Also coincidental (!) is that the so-called reviewer (rubber-stamper?) that the QHC is seeking WILL NOT be looking at the QHC's finances ... just as NHS reviewer Dr. Jack Kitts did not do!
Financial examination is purposefully left out of their purview. The Liberals don't want anyone snooping around their monopoly's hospitals asking questions that go to the heart of their political, not medical, policy; or discovering links or discrepancies between the Liberal's funding decisions and resultant medical care!

Barry Ellsworth wrote in "QHC gets no answers on financial relief after meeting with health minister, " (Belleville Intelligencer, Nov.14, 2008):

“An independent reviewer will look at plans to mop up the red ink at Quinte Health Care.

But, if mayors and QHC officials thought they'd get some hint of financial help from a meeting with the province's health minister Thursday, they left empty-handed.

Following a meeting between QHC officials, local mayors and Health Minister David Caplan in Toronto, little has changed -- the hospital still faces major service cuts and a ballooning deficit.

The reviewer -- known as a "third party" overseer "agreed upon by all parties" at the meeting Thursday -- will not look at QHC's finances, just the options drawn up by administration to cut expenses.

Those expenses could include cutting services at any of QHC's hospitals, but most likely at Trenton and Picton.

It is expected the reviewer, who has yet to be chosen, will begin his or her work in April 2009.

But, Caplan made it clear to QHC board members there would be no new money to help overcome financial woes.

"Did we get more money? No," said Belleville Mayor Neil Ellis in an interview after the hour-plus long meeting with Caplan. "Do we still need to balance our budget? Yes."

As well, QHC still has a Dec. 21 deadline to produce a plan that will detail how the hospital will ensure that it has a balanced budget at the end of two years, by March 31, 2010.

Officials from QHC and the regional body that controls health-care funding in this area -- the Local Health Integration Network -- will meet Monday to sort out the details on a reviewer.

The new development means that a special QHC board meeting set for Monday is cancelled, officials said.

Prince Edward County Mayor Leo Finnegan said the meeting with Caplan was "positive."

"No, we didn't get any money (but) the door wasn't slammed and we weren't told to go home," he said.

Laughton is on record as saying the cuts could be "heart-wrenching."

Prince Edward-Hastings MPP Leona Dombrowsky, who helped arrange and attended the session with Caplan, said there was a "fair airing of the issues."

She said the minister gave no direction on how to eliminate the deficit, but reminded everyone there was an ultimate goal in mind.

"That is about providing quality health care ... in a sustainable way," Dombrowsky said.

According to the minister, the other goal was to uncover "how did (QHC) get from a balanced position" to a deficit, she said.

To be clear, QHC has a projected deficit of $6.8 million in 2008-09, and another $8.5 million by March 31, 2010, said QHC spokeswoman Susan Rowe. That totals $15.3 million -- the figures tend to change as the days roll by and projected numbers become more concrete.

The hospital will borrow the $15.3 million from a bank and will pay off the debt over a long period of years, she said.

The financial plan to be filed by QHC to the LHIN by Dec. 21 will detail how the hospital will move forward, beginning April 1, 2010, with a balanced budget.

The hospital will still hold a series of public meetings to gather opinions from residents on which cuts are the most palatable.

"When this review process is complete, we will share the restructuring options with the board and our communities and solicit other options and ideas from them," QHC board chairman Jack Moore said.

In an interview after the meeting, Caplan said he was pleased QHC was going to "engage" residents before making any decisions on cuts.

He added he told the LHINs, who must approve any proposed cuts by hospitals, that non-clinical areas should go under the knife first and that nurses should not be laid off.

"I made that very clear ..." Caplan said. Delivering health care at a cost society can afford is a hurdle regardless of the economic times, he said.

"There has always been the challenge in health care -- the needs have always outstripped the resources that are available," Caplan said."

When Ontario’s Liberal health Minister David Caplan claims “The needs have always outstripped the resources that are available,” he is echoing the same sentiment expressed by former Liberal Health Minister George Smitherman, who also acknowledged that his Liberal government can't "do it all," (St. Catharines Standard, Aug.11, 2005)

A faulty ideology has infected both of these health-monopolist health ministers, as well as Ontario's Liberal lemming MPP's – they believe that they alone should be providing health care!

Yet, even though they KNOW they 'can’t do it all'; even though they KNOW they 'can’t provide the resources to properly fund their monopoly' - they still deny patient-consumers the right to obtain their health care elsewhere.
Let's move forward to Chris Malette's Nov.21, 2015 Inside Belleville Metroland Media report about health-care cuts being implemented in Belleville - the QHC "admitted that the news was difficult to announce. The restructuring is intended to allow QHC to remove $11.5 million in expenses next year in order to operate within its reduced funding levels from the province. This includes a $7-million reduction in administration/support departments and $4.5 million in patient care areas, QHC said"
This is the EXACT same duplicitous health care cutting template, which the Liberals did in Niagara!
Liberal healthcare hack Hoskins is doing the same things that Smitherman, Caplan, and Matthews did before him.
The healthcare budget IS SET at the whim of health minister Eric Hoskins' monopolist Liberals - therefore, cuts need to be made... end of story!
As an Ontario patient, you have no other choice - this is HoskinScare TM for you - - - thanks Dr. Eric!
And: isn't it sadly funny, how Metroland writer Chris Malette didn't even mention the words Kathleen Wynne, Liberal, or Eric Hoskins, in his story!! It's as if... let's see... oh yeah: it's as if Liberals have NOTHING TO DO WITH IT !!!
Wow!! Nice 'reporting' - anyone reading this half-story would never know that any Liberal, had anything to do with these health care cuts!!! Amazing!!!
I'm sure that if this same scenario had unfolded under 'harris', it would have been gleefully noted dozens of times per Metroland article!! (Metroland Media never lets readers down, eh, Mr. Beland Honderich?!)
Here's Belleville's MPP, Progressive Conservative Todd Smith, speaking about the QHC cuts - isn't it funny that Metroland Media reporter Malette didn't even ask the local MPP for an interview!!!
MPP Todd Smith said:
"Fall is in the air and because it is, that can only mean one thing: Another round of cuts and staff uncertainty at Quinte Healthcare hospitals. To make up for an $11.5-million funding shortfall created largely because Ontario’s Liberal government can’t manage money, jobs and services will be cut at hospitals in Picton, Belleville, Bancroft and Trenton. Money is being spent on debt that people in Prince Edward–Hastings want spent on the services they need in their hospitals.
This morning, we learned that in order to close the $11.5-million shortfall, QHC is proposing a reduction of nearly all surgery services at Trenton Memorial, $4.5 million in direct care cuts and changes that one QHC executive calls “very hard on our staff.”
During the years of this government, QHC has been the recipient of almost continual funding shortfalls from the ministry.
Speaker, if I could, I’d like to direct some comments directly to my constituency back at home: The deficit this government is running is costing you your health care services. QHC has had to come up $25 million in cuts over four years to make up for funding shortfalls because the Liberal government at Queen’s Park doesn’t have any money left. The government says money is going into better home care services but the Auditor General says services are being cut there too to pay for fat-cat salaries.
The third largest expense in the budget is how much we pay to service our debt and it’s also the fastest growing.
That’s why cuts like this have gone from being rare to happening annually."

Yet if one reads only Malette's Metroland Media 'report', one would think - as residents of Niagara were similarly conditioned to believe by their local media - that it was just the board of the local hospital who made all these 'decisions'! The link to the Ontario Liberal government's monopolist diktat of health-care cuts is not clearly made, at all!!
This is Liberal healthcare duplicity, in its finest most despotic mode.
Let's note again - before Liberal monopoly-supporting, single-payer-defending sycophants start deflecting blame onto the QHC - that the blame squarely belongs to Kathleen Wynne's health-cutting, monopoly-pushing Liberals.
As similarly happened in Niagara, the NHS and the NHS's CEO were conveniently targeted as scapegoats for implementing what were purely Liberal-mandated monopolist health-care cuts.
In Niagara, local Liberal MPP Jim Bradley sat back and smiled contentedly as the local media spun blame onto the NHS, while all along it was his Ontario Liberal government which created the phony budgets in order to manipulate the health-care cuts.
Remember the meme: health care cuts are 'good' when Ontario's monopolist Liberals or the NDP do it!

No comments: