Dr. P. Dobrovolskis and Dr. Kevin Speight wrote in "An open letter to the citizens of Niagara", (Niagara This Week, Oct.2, 2009):
"The Greater Niagara General Hospital Emergency Physician Group has been one of the most constant and reliable groups in Canadian emergency services, providing dedicated and quality care for the citizens of the Niagara Region for over 25 years. We have the distinction in the Niagara region of having the lowest wait times, best patient satisfaction rates and service to the citizens of Niagara.
Our physicians have been dedicated in providing the Niagara community with specialized services such as the Regional Stroke Treatment Centre, the Regional Chemical Biological Disaster Decontamination Unit, the site of the Base Hospital Program which provides advice and training to paramedics in the region as well as providing charitable medical services in the Third World. This emergency department handles more patients than any other emergency department in the region all with one of the most experienced and longest serving group of physicians in Niagara. The emergency physicians in Niagara Falls have long ties to the community and have served the community with pride, ensuring the best possible emergency care for the patients of this growing region.
Despite this, the department has been under constant attack by its own administration on a professional and personal level.
The agenda of the NHS administration is unclear, even after the token dismissal of the former chief of staff and the promise of transparency, accountability and cooperation with the medical staff, the NHS has only become more entrenched in a restructuring plan that is covert and kept hidden from the public as well as the staff of the NHS.
Over the last one-and-a-half years the NHS has kept a private for-profit physician temporary agency on retainer, at a cost of $20,000 per month. This company would provide physicians at significant cost to the NHS to replace the current emergency physicians in the event the physicians would not comply with NHS restructuring.
During this same time, the emergency doctors of the GNGH have been frustrated by bed closures, cuts to nursing and practical nursing staff, sudden and unexplained closure of services such as pediatrics, obstetrics and mental health without warning or explanation. The GNGH is dying a slow death by cuts that will transfer the bulk of services away from our hospital and the people it serves to other facilities in locations that do not serve the community’s interests.
The latest blow to the emergency department physicians is the demand to dismantle a stable schedule for our emergency room doctors and bring in contract physicians by September 15th, 2009, this despite no proof of benefit and at great cost to the region. The real issues of bed and nursing staff shortages are being ignored. Staffing more physicians per shift might appear to reduce wait times in the emergency department but in practice will not be effective. The long wait times do not currently result from the number of available doctors but are due to the number of patients that are held in the department, waiting for a bed to be admitted into. The staffing model in use by the emergency physicians has provided stability in emergency room physician coverage unrivaled in the region, and continuity of care. Over the past years the NHS administration have cut nurses and closed beds, increasing the patient wait times.
Adding more doctors will not solve this issue unless additional beds and nursing support are also made available. The emergency physicians have been given an ultimatum to sign on to the new model or leave and be replaced by temporary agency doctors. Agency doctors and their private for-profit company are guaranteed payment and “top-ups”; there is little incentive for them to reduce wait times. The current physicians do not bill the NHS and have no top-ups or extra fees. They bill the Ministry of Health only for the services they provide, no service charges or administrative costs and create no extra financial burden for the regional health care budget.
We are also faced with uncertainty as to what kind of hospital Greater Niagara General will be in the next months. Unexpected closures of pediatrics, obstetrics, gynecology and psychiatry have left the emergency physicians scrambling to find places for patients in other hospitals, far from their homes in Niagara. With other reductions in services patients languish on stretchers in the emergency room often for days and to help reduce the burgeoning $110-million dollar deficit of the NHS.
Despite our long record of service to the community, our record of performance above the benchmarks within the Niagara Health System, lowest level of complaints and shortest wait times and the dedication of the emergency physicians of the Greater Niagara General Hospital, the Niagara Health System administration appears committed to the dismantling of our hospital emergency department.
After careful discussion we feel that we can no longer partner with the NHS and have lost confidence in the leadership of the emergency department and overall administration of the Niagara Health System. It is with great sadness and frustration that we announce we can no longer participate in providing scheduled coverage of the emergency department of the Greater Niagara General Hospital as of 8 a.m. on the 1st of October, 2009. We will provide full coverage until then and have offered to assist in providing services for the community by covering some shifts for a transition period to fill the voids left by our departure.
We realize the impact this will have on the quality of care in the region, the potential loss of the Stroke Treatment Program and Chemical Biological Disaster Decontamination Unit as well as community participation we have enjoyed, but we feel we have no other option.
We wish as a group to express our thanks and deepest sentiments to our nurses, fellow physicians and community that have strived to build this hospital into the bright light of the NHS and supported us over these many decades.
With Deepest Regrets, Dr. P. Dobrovolskis, Dr. Kevin Speight."
*
Well - what do Niagara's local Liberal health care monopolists, MPP's Jim Bradley and Kim Craitor, have to say about the above-mentioned "bed closures, cuts to nursing and practical nursing staff, sudden and unexplained closure of services such as pediatrics, obstetrics and mental health without warning or explanation"?!?
Its funny, isn't it, how no mention in the above letter was made about the role of the local Liberals in these health care cuts! Nothing!!
It's as if these cuts just happened, solely at the whim of the NHS!!
In fact, it was Liberal health care monopolists Kim Craitor and Jim Bradley who were cutting Niagara's health care - - - while they were blowing a billion dollars on eHealth!
Why isn't anyone asking Liberal MPP's Bradley or Craitor for accountability, and for an explanation?
The health-care monopoly known as the NHS had been ordered by their Liberal monopolist bosses - the Incompetent Dalton McGuinty Liberal Government - to cut costs, remember?!?
McGuinty's majority Liberals have been in complete control of Ontario's health monopoly since 2003!!
In Niagara, it was the Liberal-created, Liberal-appointed LHIN which approved all the "cuts" which the good doctors mentioned - - - yet, amazingly, the good doctors never mentioned a word about the Liberal LHIN - or about the Liberals!!! Funny, huh?
Let's put the blame where it belongs: on incompetent Liberal ideologues who force single-payer health care monopolism upon the citizens of Ontario.
*
Continuing in the vein of blaming the NHS, but not the NHS's bosses, Susan A. Salzer wrote in "NHS systemic failures revealed", (Niagara This Week, Oct.8, 2009):
"For many months now the Hospital proponents from Fort Erie have been reporting persistent problems within the NHS.
When a “Code Gridlock” was recently initiated, it was indicative of overcrowded emergency rooms, ambulance backlogs and a shortage of beds.
Since the closure of the operating rooms in Port Colborne and Fort Erie, the OR’s in Welland have experienced delays and cancellation of scheduled surgeries.
In St.Catharines despite an infusion of 2.5 million dollars to the Emergency Room in the last two years, there has been very little impact on the wait times which remain at over 20 hours for complex care.
Niagara Falls has experienced the loss of four Emergency Room Doctors and the Ontario Nurses Association has cited a “life-threatening” shortage of Emergency Room Nurses and have requested the Ministry of Health to investigate the NHS.
Despite a budgetary increase of 43 per cent in the last six years the NHS continues to close beds, reduce programs and issue staff reductions.
And now the NHS Emergency Medicine site chief Dr. Maynard Luterman confirms “there is a problem in the system.”
We can confirm to Dr. Luterman that this is not breaking news . . . problems in the system have been repeatedly reported by the citizens of Fort Erie. He further questioned if the “NHS should be beat up over it?” The simple answer is an unmitigated YES. As the program planners, managers and administrators of this chaos who else should be held responsible?
When a system is broken, fix it by replacing all administration personnel who can be held responsible for creating a health system in Niagara where we experience a mortality rate 34 per cent higher then the Provincial average.
We continue in the Southern Tier to object to second-rate Health care."
*
Well, of course there is a systemic failure in Dalton McGuinty's Incompetent Liberal-run health system: the failure is caused by ideological Liberal adherence to single-payer health monopolism. Liberals refuse to acknowledge this paradigm: they continue to believe that more socialism, more state control, more state intrusion, and correspondingly less patient payer and provider choice [and, naturally, less government accountability and transparency] is the answer.
In other words, the solution to the last forty-years-worth of state-run single-payer failure - is more government control!!
Salzer advocates that the NHS should be "beat up" over the problems in the system - yet Salzer does not mention the local Liberal MPP's and their Liberal government's complicity in this situation!!
Is the NHS to blame for the health care cuts imposed by their Liberal bosses - incompetent Liberal fools such as Smitherman, Caplan, Matthews, Bradley, and Craitor?
Are these Liberals to be held harmless, while the NHS gets beaten up??!!
Come on!
Salzer even asks "who else should be held responsible" - yet, she can't bring herself to blame her single-payer-pushing Liberal government!
Salzer even mentions Niagara's mortality rate being 34 per cent higher than the Provincial average - yet, once again, she cannot connect her own dots to the single-payer, monopolist, anti-patient-choice, Tommy-Douglas-bastardized health-care failures of the McGuinty Liberal government!
The "overcrowded emergency rooms, ambulance backlogs and a shortage of beds" which Salzer writes of, are a gift from your LOCAL LIBERAL health care monopolists! This is the legacy of statist monopoly health care! What else COULD you expect??
Salzer writes that 'we object to Niagara's second-rate health care' - but what we should really be objecting to is the failed Liberal single-payer ideological monopoly that spawned it!
*
"The Greater Niagara General Hospital Emergency Physician Group has been one of the most constant and reliable groups in Canadian emergency services, providing dedicated and quality care for the citizens of the Niagara Region for over 25 years. We have the distinction in the Niagara region of having the lowest wait times, best patient satisfaction rates and service to the citizens of Niagara.
Our physicians have been dedicated in providing the Niagara community with specialized services such as the Regional Stroke Treatment Centre, the Regional Chemical Biological Disaster Decontamination Unit, the site of the Base Hospital Program which provides advice and training to paramedics in the region as well as providing charitable medical services in the Third World. This emergency department handles more patients than any other emergency department in the region all with one of the most experienced and longest serving group of physicians in Niagara. The emergency physicians in Niagara Falls have long ties to the community and have served the community with pride, ensuring the best possible emergency care for the patients of this growing region.
Despite this, the department has been under constant attack by its own administration on a professional and personal level.
The agenda of the NHS administration is unclear, even after the token dismissal of the former chief of staff and the promise of transparency, accountability and cooperation with the medical staff, the NHS has only become more entrenched in a restructuring plan that is covert and kept hidden from the public as well as the staff of the NHS.
Over the last one-and-a-half years the NHS has kept a private for-profit physician temporary agency on retainer, at a cost of $20,000 per month. This company would provide physicians at significant cost to the NHS to replace the current emergency physicians in the event the physicians would not comply with NHS restructuring.
During this same time, the emergency doctors of the GNGH have been frustrated by bed closures, cuts to nursing and practical nursing staff, sudden and unexplained closure of services such as pediatrics, obstetrics and mental health without warning or explanation. The GNGH is dying a slow death by cuts that will transfer the bulk of services away from our hospital and the people it serves to other facilities in locations that do not serve the community’s interests.
The latest blow to the emergency department physicians is the demand to dismantle a stable schedule for our emergency room doctors and bring in contract physicians by September 15th, 2009, this despite no proof of benefit and at great cost to the region. The real issues of bed and nursing staff shortages are being ignored. Staffing more physicians per shift might appear to reduce wait times in the emergency department but in practice will not be effective. The long wait times do not currently result from the number of available doctors but are due to the number of patients that are held in the department, waiting for a bed to be admitted into. The staffing model in use by the emergency physicians has provided stability in emergency room physician coverage unrivaled in the region, and continuity of care. Over the past years the NHS administration have cut nurses and closed beds, increasing the patient wait times.
Adding more doctors will not solve this issue unless additional beds and nursing support are also made available. The emergency physicians have been given an ultimatum to sign on to the new model or leave and be replaced by temporary agency doctors. Agency doctors and their private for-profit company are guaranteed payment and “top-ups”; there is little incentive for them to reduce wait times. The current physicians do not bill the NHS and have no top-ups or extra fees. They bill the Ministry of Health only for the services they provide, no service charges or administrative costs and create no extra financial burden for the regional health care budget.
We are also faced with uncertainty as to what kind of hospital Greater Niagara General will be in the next months. Unexpected closures of pediatrics, obstetrics, gynecology and psychiatry have left the emergency physicians scrambling to find places for patients in other hospitals, far from their homes in Niagara. With other reductions in services patients languish on stretchers in the emergency room often for days and to help reduce the burgeoning $110-million dollar deficit of the NHS.
Despite our long record of service to the community, our record of performance above the benchmarks within the Niagara Health System, lowest level of complaints and shortest wait times and the dedication of the emergency physicians of the Greater Niagara General Hospital, the Niagara Health System administration appears committed to the dismantling of our hospital emergency department.
After careful discussion we feel that we can no longer partner with the NHS and have lost confidence in the leadership of the emergency department and overall administration of the Niagara Health System. It is with great sadness and frustration that we announce we can no longer participate in providing scheduled coverage of the emergency department of the Greater Niagara General Hospital as of 8 a.m. on the 1st of October, 2009. We will provide full coverage until then and have offered to assist in providing services for the community by covering some shifts for a transition period to fill the voids left by our departure.
We realize the impact this will have on the quality of care in the region, the potential loss of the Stroke Treatment Program and Chemical Biological Disaster Decontamination Unit as well as community participation we have enjoyed, but we feel we have no other option.
We wish as a group to express our thanks and deepest sentiments to our nurses, fellow physicians and community that have strived to build this hospital into the bright light of the NHS and supported us over these many decades.
With Deepest Regrets, Dr. P. Dobrovolskis, Dr. Kevin Speight."
*
Well - what do Niagara's local Liberal health care monopolists, MPP's Jim Bradley and Kim Craitor, have to say about the above-mentioned "bed closures, cuts to nursing and practical nursing staff, sudden and unexplained closure of services such as pediatrics, obstetrics and mental health without warning or explanation"?!?
Its funny, isn't it, how no mention in the above letter was made about the role of the local Liberals in these health care cuts! Nothing!!
It's as if these cuts just happened, solely at the whim of the NHS!!
In fact, it was Liberal health care monopolists Kim Craitor and Jim Bradley who were cutting Niagara's health care - - - while they were blowing a billion dollars on eHealth!
Why isn't anyone asking Liberal MPP's Bradley or Craitor for accountability, and for an explanation?
The health-care monopoly known as the NHS had been ordered by their Liberal monopolist bosses - the Incompetent Dalton McGuinty Liberal Government - to cut costs, remember?!?
McGuinty's majority Liberals have been in complete control of Ontario's health monopoly since 2003!!
In Niagara, it was the Liberal-created, Liberal-appointed LHIN which approved all the "cuts" which the good doctors mentioned - - - yet, amazingly, the good doctors never mentioned a word about the Liberal LHIN - or about the Liberals!!! Funny, huh?
Let's put the blame where it belongs: on incompetent Liberal ideologues who force single-payer health care monopolism upon the citizens of Ontario.
*
Continuing in the vein of blaming the NHS, but not the NHS's bosses, Susan A. Salzer wrote in "NHS systemic failures revealed", (Niagara This Week, Oct.8, 2009):
"For many months now the Hospital proponents from Fort Erie have been reporting persistent problems within the NHS.
When a “Code Gridlock” was recently initiated, it was indicative of overcrowded emergency rooms, ambulance backlogs and a shortage of beds.
Since the closure of the operating rooms in Port Colborne and Fort Erie, the OR’s in Welland have experienced delays and cancellation of scheduled surgeries.
In St.Catharines despite an infusion of 2.5 million dollars to the Emergency Room in the last two years, there has been very little impact on the wait times which remain at over 20 hours for complex care.
Niagara Falls has experienced the loss of four Emergency Room Doctors and the Ontario Nurses Association has cited a “life-threatening” shortage of Emergency Room Nurses and have requested the Ministry of Health to investigate the NHS.
Despite a budgetary increase of 43 per cent in the last six years the NHS continues to close beds, reduce programs and issue staff reductions.
And now the NHS Emergency Medicine site chief Dr. Maynard Luterman confirms “there is a problem in the system.”
We can confirm to Dr. Luterman that this is not breaking news . . . problems in the system have been repeatedly reported by the citizens of Fort Erie. He further questioned if the “NHS should be beat up over it?” The simple answer is an unmitigated YES. As the program planners, managers and administrators of this chaos who else should be held responsible?
When a system is broken, fix it by replacing all administration personnel who can be held responsible for creating a health system in Niagara where we experience a mortality rate 34 per cent higher then the Provincial average.
We continue in the Southern Tier to object to second-rate Health care."
*
Well, of course there is a systemic failure in Dalton McGuinty's Incompetent Liberal-run health system: the failure is caused by ideological Liberal adherence to single-payer health monopolism. Liberals refuse to acknowledge this paradigm: they continue to believe that more socialism, more state control, more state intrusion, and correspondingly less patient payer and provider choice [and, naturally, less government accountability and transparency] is the answer.
In other words, the solution to the last forty-years-worth of state-run single-payer failure - is more government control!!
Salzer advocates that the NHS should be "beat up" over the problems in the system - yet Salzer does not mention the local Liberal MPP's and their Liberal government's complicity in this situation!!
Is the NHS to blame for the health care cuts imposed by their Liberal bosses - incompetent Liberal fools such as Smitherman, Caplan, Matthews, Bradley, and Craitor?
Are these Liberals to be held harmless, while the NHS gets beaten up??!!
Come on!
Salzer even asks "who else should be held responsible" - yet, she can't bring herself to blame her single-payer-pushing Liberal government!
Salzer even mentions Niagara's mortality rate being 34 per cent higher than the Provincial average - yet, once again, she cannot connect her own dots to the single-payer, monopolist, anti-patient-choice, Tommy-Douglas-bastardized health-care failures of the McGuinty Liberal government!
The "overcrowded emergency rooms, ambulance backlogs and a shortage of beds" which Salzer writes of, are a gift from your LOCAL LIBERAL health care monopolists! This is the legacy of statist monopoly health care! What else COULD you expect??
Salzer writes that 'we object to Niagara's second-rate health care' - but what we should really be objecting to is the failed Liberal single-payer ideological monopoly that spawned it!
*
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