Sunday, November 2, 2008

Liberals underfund Niagara health-care while denying link to high patient death-rate in St. Catharines

Above: Dr. Jack Kitts, standing, reports to the LHIN board at its meeting Oct.28, 2008 in Niagara Falls, Ont. Watching from the left are NHS chair Betty-Lou Souter , NHS CEO Debbie Sevenpifer, and NHS Chief of Staff, Dr. Bill Shragge. Photo by R. Bobak

In  Liberal health-care in Ontario: pay more, get less  I wrote we should be looking at what the NHS is rather than where it is – and, after all the recent hoopla with the NHS and its numerous reviews, we’re told (surprise, surprise) by Dr. Kitts that what the NHS is - wait for it - is UNDERFUNDED!

You don’t say!
Wasn’t it Ontario’s Liberals who for years have SET the budgets and the funding?
Wasn’t it Ontario Liberals who constantly denied that there was ANY PROBLEM with their health-care system, let alone with their funding model – i.e. Ontario's government-run, single-payer monopoly where patients are forced to wait for Liberal-rationed health-care services?
Wasn’t it the Liberals who created the hated multi-billion dollar Health Tax in order to ostensibly IMPROVE health care?!

So now, Kitts tells us what had already been obvious, and what the McGuinty Liberals have always denied, and attempted to cover up: that the NHS is underfunded.

The shortage of cash has resulted in the deferral of plant and equipment expenditures,” Kitts stated about the NHS in his written report to the LHIN. “While some capital investments can be deferred, they likely cannot be eliminated, and inappropriate business and clinical decisions may be made in the meantime.” The Liberals have been UNDERfunding the NHS for years – the question now is: has the “shortage of cash” for capital investments, or for operating budgets, already caused “inappropriate” business or clinical decisions affecting patient health?
How will we ever know?!
Are we just supposed to believe that the systemic problems in the NHS will magically disappear when the new hospital is built - or will the same problems just transfer over there?

(During his verbal presentation, Kitts briefly mentioned helicopters being used elsewhere to transport patients. What, will the LHIN, which is running the NHS into deficit, now run and fund an air ambulance for Niagara as well? That’ll be the day. More likely, for many Niagarans it would be better to be transported, by air or by bridge, to Buffalo for health-care that they can’t get in Ontario. Hope Ole Jimmy, the Transportation Minister, has been working on those health care Emergency Exit lanes at the border: see: Will Liberal Transport Minister Jim Bradley open new 'sicko' lanes at U.S. border to ease Canadian healthcare exodus? )

Why isn’t local St. Catharines Liberal MPP Jim Bradley explaining why his Liberals are underfunding their health monopoly – right in Niagara? Is anyone even asking him? A vaporous Bradley has nothing to say about anything… why, Jimmy’s busy banning cellphone use in cars while merely phoning-in his own duties as St. Catharines MPP!

(A story in the Oct.30, 2008 St. Catharines Standard, "Rifts remain over NHS plan", read : "St. Catharines MPP Jim Bradley, who previously declined to comment on the NHS plan until Kitts delivered his report, said he did not want to comment Wednesday. "I still have to read the full report, and then the LHIN has to make a decision on it," he said. "As much as possible, I think politics should be kept out of this."
Bradley now wants 'to keep politics out of health-care' ??!
Is he for FLICKING real?
This from the flicking Liberal partisan who for years earned his living constantly posturing and blustering about health-care, spewing his monopolist rhetoric and his Liberal health-care duplicity far and wide? The gall of this smarmy hypocrite to now pretend and plead that somehow "politics should be kept out of this"... when "this" is ALL ABOUT politics: about failing, duplicitous Liberal politics which Liberal hack Bradley conveniently now wants us overlook!
Hypocrite, thy name is Jim Bradley.)

Although the St. Catharines Standard’s Doug Herod lambastes Niagara Falls Liberal MPP Kim Craitor, of Doofus Lane, in his Oct.31, 2008 column (below), Herod (again, surprise, surprise) doesn’t once mention our Li’l Liberal Golden Boy, Good Ole Jimmy Bradley (of Teflon Trail, just down the street from Do-Nothing Drive), or Bradley’s role in this NHS review/funding/consolidation issue.

Why, Ole Jimmy Bradley has himself done what he sanctimoniously accused that Mike Harris would do!
And Bradleyites in the press happily go along for the ride as fifth columnists for the Liberal government!
Good Ole Jimmy, who once blustered that St. Catharines couldn't get by with one active treatment centre, now brings us one active treatment centre (!!)... and brings us closures - pardon, ‘centre of excellence’ consolidations - in other areas!!
Niagara South residents have now seen for themselves, first-hand, the kind of bait-and-switch political tactics that are the foundation of Liberal Healthcare Duplicity.

No mention from Herod about the Liberal government’s hospital funding model, or what Bradley’s position is/was on that.
No mention from Herod on what the real reason was for this storied NHS ‘organizational-review’ cum review-of-reviews cum HIP cum Kitts report!!
Wasn’t the initial reason for this series of reviews caused by a Nov.29, 2007 CIHI study which revealed that the NHS’s St. Catharines General Hospital had the third-highest patient death-rate in Canada? (St. Catharines Standard report, Dec.7, 2007)
Weren’t these revelations linked to years of Liberal underfunding?
Didn’t former Liberal Health Minister Smitherman even suggest that the NHS, like drunken sailors, was spending too much (!!) and needed to live within its means?
Didn’t the Liberal government outright DENY that their hospital funding model had anything to do with the CIHI revelations (see: High patient death rates deserve only "routine" Liberal review ) or with the subsequent ‘review-of-reviews’ process, which then culminated in Kitt’s Oct.28, 2008 verbal report to the local Hamilton Niagara Haldimand Brant LHIN?

Since the CIHI study was released - almost a year ago, on Nov.29, 2007 - an arrogant and secretive Liberal Jim Bradley has refused to publicly explain the high NHS death-rate found in the hospital which his own government runs in his own city!
What are Bradley and his Liberal government hiding?
Why didn’t Bradley immediately call for an independent (if not a criminal) investigation into this report’s extremely troubling revelations? What is Bradley, the single-payer healthcare monopoly-pusher, trying to cover up?
What we have seen here, with all the post-CIHI-study chain of subsequent ‘reviews’, is just a Liberal-orchestrated smoke and mirror campaign to justify cuts and consolidations in their health monopoly: no reasons have been provided to explain the mortality-rate/funding model questions – issues which directly link to the Liberal’s monopolistic Commitment to the Future of Medicare Act, and to the Liberal’s dangerous philosophical no-patient-payer-choice-at-any-cost health-care demagoguery.

When Debbie Sevenpifer said (in “Funding boost urged to help cure NHS woes”, St. Catharines Standard, Nov.1, 2008, below): “If we are to get to a balanced budget, we really only have two options … Either we receive more funding or we make deeper cuts than we already have,” she certainly clearly conveyed the stark constraints that the puppet-master Liberal government and its Liberal-appointed LHIN puppets have placed on Ontario's health-care administrators.
But there is a third option: that the patient - not solely the government - be allowed to choose their health-care payment and provider options.

This is the real heart of the debate which the Ontario Liberal government avoids.


Doug Herod wrote in “Report calls for more funding for Niagara Health System” (St. Catharines Standard, Oct.29, 2008):

“The substance of Dr. Jack Kitts's much-awaited hospital report was never in doubt.
It's the reaction to it from the Niagara community at large that's the big question mark.
Will citizens, politicians and health-care professionals acknowledge -- grudgingly in some cases -- that the path to quality health delivery has been properly identified and, thus, agree to collaborate on its implementation as Kitts pleaded?
Or will certain elements continue to whine, complain, obstruct, stomp their feet and threaten to hold their breath until they get their way?
For his part, Kitts, president of The Ottawa Hospital, couldn't have delivered a clearer message when he submitted his review of the Niagara Health System's hospital improvement plan Tuesday.
Grow up, Niagara, and start acting like a region of shared interests rather than a collection of competing turf-protectors, or watch the overall quality of health care here continue to diminish.
So, will there be peace in our time?
Well, on the one hand, we did manage, however painfully, to eventually put long-standing animosity between Hotel Dieu and St. Catharines General supporters behind us.
On the other hand, there was to be a vote the other night on an NHS medical staff association motion to change the location of the new St. Catharines hospital.
I mean, what hope is there for Niagara's medical services community to pull together to improve health care when a significant segment remains so delusional about its ability to influence the hospital site at this stage in the proceedings?
Then again, maybe they were just trying one last Hail Mary pass.
Sorry, gang, your touchdown attempt came up 85 yards short.
Surely, no one who heard Kitts's presentation Tuesday and the Local Health Integration Network's reaction to it will have any doubt that the essential components of the NHS plan will be approved for implementation.
Indeed, given that the plan doesn't achieve the cost savings needed to balance the budget, a more worrisome prospect for turf-protectors in Niagara would be the LHIN figuring Kitts and the NHS didn't go far enough in eliminating duplication and inefficiencies.
Both Fort Erie and Port Colborne were thrown a bone when Kitts recommended their hospitals' urgent care centres be open 24/7 rather than close overnight.
Ladies and gentlemen of these two fine burgs, know a good thing when it's been handed to you. (This recommended tweaking to the hospital plan is far from a sure thing, though. It would cost an already financially strapped NHS more dough to keep these centres open longer and Kitts said they should be monitored to see if they are cost-efficient and providing needed health care.) The other major controversy of the NHS's plan was moving the baby-delivery service to one site, specifically St. Catharines.
The chances of the status quo -- maternity wards at three sites -- remaining in place are zero, zilch, nada.
A new hospital is being built in Niagara's largest community. Ergo, the recommendation is that the one maternity ward go there. That may be tough to swallow for some, but it's hardly a wacko move.
Again, though, none of this is new.
Health-care providers have known for years there's a critical-mass problem in Niagara as we've tried to be all things to all people without the finances, equipment or human resources to pull it off.
And, make no mistake about it, centralizing certain services in order to create a sufficiently large pool of patients for various specialties will win the favour of bureaucrats up the provincial food chain.
It's inconceivable the province is going to throw loads of cash at Niagara to make the turf-protection model work.
What's that, you think we're special? Right. Tell that to folks in Barrie,
Kitchener, Windsor, Oshawa or anywhere else in Ontario.
It's time -- no, make that way past time -- to hop aboard the Niagara unity train.”


Speaking of Liberals who mindlessly believe that only a 'health-monopoly' can masquerade as a 'health-system', here's Doug Herod writing in “Falls MPP mindlessly masquerading as health minister”, St. Catharines Standard, Oct.31, 2008. (my comments in italics):

“Shame about Kim Craitor's Halloween costume idea going up in smoke.
The Niagara Falls MPP was all set to go out as Ontario Health Minister David Caplan.
What the heck, Craitor had been strutting around like the minister for over a year. Might as well throw on a Caplan mask and complete the picture.
Alas, Craitor's costume idea died this week when Dr. Jack Kitts submitted his review of the Niagara Health System's hospital improvement plan.
Turns out Craitor's self-styled role as Niagara's health minister was a fraud. His blatherings about what needed to be done here were exposed as, well, blatherings. (wasn't the real fraud, of course, George Smitherman blathering about the superiority of Liberal health-care?)
Fat good the mask would do now.
Seriously, in this latest hospital saga has anyone come across as a more hapless figure than Craitor? (hmm: Bradley... McGuinty... Smitherman..?)
Yeah, I realize there are a fair number of contenders. But one can excuse local politicians for getting overly excited. It's what happens when dealing with an issue outside their jurisdiction. Free of any responsibility or accountability, they can simply rail away at the actions of others and offer expensive pie-in-the-sky solutions.
(John Maloney, Joyce Morocco)
As for south Niagara docs, their comfort zones have been rocked. The need to blow off steam is understandable, even if a fair bit of the venting is absurdly directed at moving the new St. Catharines hospital location.
(from one absurd location to another?)
But Craitor?

Egads, the man's part of the provincial government!
You'd think the Liberal backbencher would know a thing or two about how these things work.
Guess not.
Craitor's trip down Doofus Lane (is that near the corner of Dorkus and Useless, where McGuinty and Bradley usually travel?) started during the 2007 election campaign (compared to Jim Bradley's trip down Doofus Lane, which started - egads - in 1977) when he complained that the NHS was "too big and too complicated" to be efficiently managed. He suggested it might be wise to return to the happy days when each Niagara community hospital had its own independent governance.
Yeah, right. And Ozzie and Harriet is coming back on the air, too. (which roles will Jimmy and Kimmy be playing?)
I suppose Craitor could be forgiven if this was simply a lame attempt to win votes. After his election win, though, he continued to call for some vaguely defined operational review of the NHS.
(but strangely - and regrettably - Craitor did NOT call for a review of the NHS's high death-rate as was revealed by the Nov.29, 2007 CIHI study... why?)
At the time, it didn't take a genius to suggest Craitor better be careful what he wished for. Rather than try to be all things to all communities, it was more likely a review would conclude the cash-strapped NHS should centralize more of its services at fewer sites. (which by all accounts is what the previous Ontario government attempted to phase in - to hoots of smug derision from the same politicians and pundits who are now in favour of the same strategy!
Oh, and Doug: exactly who caused the NHS to become "cash-strapped"??! Couldn't have been the Liberals, eh, Doug??)
This prospect was never raised in Craitor's world. Instead, his musings helped further delude anti-NHS types into thinking their home turfs could be protected from any future restructuring.
(it also shows the foolishness of relying solely on deluded Liberals who promote a dangerous, unaccountable, single-payer, non-competitive government-run health monopoly)
In June, the Local Health Integration Network ordered the NHS to develop a plan that would address a seemingly chronic operating deficit.
(What...? A deficit?!? A deficit caused by Liberal-legislated budget constraints within their no-patient-choice health MONOPOLY?!? Where did the Liberal McGuinty Health Tax billions go?)
Craitor crowed that it was the review he had been pushing for, an assertion that raised more than a few eyebrows.

After all, this wasn't an outside (the Liberals sure did NOT want that!) study that looked at governance and administrative structure. Rather, it was an inhouse review (phew...THAT'S what Liberals wanted - and then engineered: a pre-ordained, window-dressed "in-house review" which they directed and manipulated from the beginning. The Liberals circled their health-care wagons after the severity of the CIHI report was revealed) of service delivery, with an eye towards finding cost-savings. (Let's note that Jim Bradley would later go on to claim that the HIP (which resulted from these Craitor-instigated phony reviews) was NOT about "cost-savings"!!!!!)
"I'm excited the process has started," said Craitor, whose riding includes Fort Erie. (but, the real process, which has already started, is actually the McCreith /Holmes constitutional challenge against the McGuinty Liberal's monopolistic health-care policies)
As it turned out, Craitor was taking credit for a process that has paved the way for Niagara Falls to lose its maternity ward and Fort Erie to have its emergency ward and surgery status diminished.

Well done, Kim! (...and YOU, Doug, neatly deflected any mention of the CIHI death rate, nor its link to Liberal single-payer health policies... well done!!)
Since the improvement plan was released in mid-summer, Craitor has scrambled to win back favour with the local nose-out-of-joint contingent, primarily by trashing the NHS.
"The NHS is really a sick puppy; it needs a lot of help and advice," said the health-expert wannabe, who proceeded to give help and advice. (as compared to "health-expert" Jim Bradley, who proceeded to do what, exactly? And, isn't the LHIN also a sick puppy - as well as the Liberal government which spawned it?!)
In mid-September, Craitor said that while he still supported the construction of a new community hospital and cancer centre in St. Catharines, he suggested all obstetric and pediatric services be moved to Niagara Falls rather than the Garden City, as was recommended in the NHS plan.

Mindless parochialism, thy name is Craitor.
As flames of discontent be fanned in his riding, Craitor's support for the St. Catharines hospital site weakened.
"In terms of location, I do have concerns now," he said earlier this month, suggesting that if the new hospital gets sole responsibility for obstetrics and pediatrics in Niagara then the location "comes back into play."
I mean, you'd think Craitor would have had the opportunity to accidentally bump into Health Minister Caplan or Infrastructure Minister George Smitherman at a Liberal caucus meeting and be told that those who believe the site can be changed should really cut back on their hallucinogens.
Did I mention Craitor was a hapless figure in this saga?
I was being kind.”

Grant LaFleche reported in “Funding boost urged to help cure NHS woes”, (St. Catharines Standard, Nov.1, 2008):

“The Niagara Health System needs a large and permanent infusion of provincial government funding to carry out its plans for hospital operations, says a report by the president of The Ottawa Hospital.
Without new money, the NHS’s financial situation — which includes an accumulated deficit of more than $100 million — could become unmanageable, the report says.
Dr. Jack Kitts’s report, released Friday, said patient care will continue to decline if the NHS doesn’t receive adequate levels of funding.
“The shortage of cash has resulted in the deferral of plant and equipment expenditures,” Kitts wrote. “While some capital investments can be deferred, they likely cannot be eliminated, and inappropriate business and clinical decisions may be made in the meantime.”
Kitts, who gave an overview of his report Tuesday in Niagara Falls, does not indicate how much money the NHS needs, but he does point out that its funding “is lower than peer hospitals for their level of patient activity.”
Debbie Sevenpifer, NHS president and chief executive officer, said the regional hospital system needs between $15 million and $20 million annually in addition to its about $370-million budget.

“If we are to get to a balanced budget, we really only have two options,” Sevenpifer said Friday. “Either we receive more funding or we make deeper cuts than we already have.”
Kitts reviewed the NHS’s hospital improvement plan, designed to reduce costs and improve patient care, for the Hamilton Niagara Haldimand Brant Local Health Integration Network (LHIN), the body responsible for planning and funding of health care in Niagara.
The report praised the improvement plan as a “good clinical plan that addresses quality care,” but will not resolve the NHS’s ongoing financial crisis.
Kitts paints a bleak picture of NHS finances. It is presently carrying an accumulated annual deficit of nearly $117 million and a long-term debt of $13.9 million.
“Given the NHS’s own financial projections and the reviewer’s comments on both the (hospital improvement plan) assumptions and capital requirements, it is not clear how the NHS can continue to manage its financial situation without a substantial, permanent cash infusion,” the report says.
Kitts also characterized the cost-cutting measures of the plan as “very aggressive,” but warned there are few avenues of cost saving left open to the NHS.
“The NHS will not be able to count on substantial efficiency and productivity gains to contribute materially to its financial challenges,” he wrote.
Sevenpifer conceded that like many other Ontario hospital systems, the NHS is facing a serious cash crunch.
But she said Kitts’s endorsement of the overall plan is proof “we are headed in the right direction.”
She said the improvement plan will eventually result in savings that will, over the long term, help bring about balanced budgets. But, like Kitts, she said more money from the province is needed.
The report also recommends the NHS work to heal rifts with its own medical staff and the community at large and suggests the NHS hire an adviser for that purpose.
Kitts’s report will be reviewed by the LHIN by the end of the year.
Sevenpifer said while the NHS can start to work on recommendations to improve community and staff relationships, any recommendations Kitts made regarding service have to be reviewed by the LHIN first.”

Clearly, the Liberals have underfunded the health-care system in Niagara.Yet, after all this, St. Catharines Liberal MPP, health-care monopolist Jim Bradley only sings the sound of silence regarding the failing health-scare monopoly which he so-trumpeted.
Maybe this new "advisor" which Kitts recommends can prepare the NHS for the post-McCreith/Holmes world that they should have seen post-Chaoulli.

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