health

Saturday July 27, 2019

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Saturday July 27, 2019

Ontario’s health reforms loaded with risk and reward

This week The St. Catharines Standard and The Hamilton Spectator did something uncommon. The sister news organizations published a joint investigative feature on health-care reform in Ontario.

April 6, 2019

We did it together because the issues and challenges involved are shared by citizens of Hamilton and Niagara. The Local Health Integration Network, to be replaced by a new oversight body, covered both regions. It made sense to share our joint expertise, personified by Joanna Frketich of The Spectator and Grant LaFleche of The Standard.

We’re proud of the series, which is the most comprehensive reporting on the most significant reform to Ontario’s health system in recent history. We explained what we could, and were forthright about what we don’t know — which is a lot given the vagueness and lack of detail in the strategy.

March 19, 2019

That’s the worry. There is great potential in the reform plan. While we are not among those who describe the current system as broken, there’s no doubt it is underperforming, and too often failing health-care consumers. So you cannot fault the Ford government for wanting to improve the system, especially at a time when an aging population will increase use of and stress on health care.

There is also great risk, as there would be with any attempt to change something as vast, complex and critical as health care. If it’s not done right, the costs could be very high. Unfortunately, this government’s track record at getting things right is not stellar. The autism debacle. Public health cuts that had to be temporarily reversed. Breaking a beer company contract that will probably cost millions. Killing cap and trade for ideological reasons, forcing Ottawa to implement a carbon tax, and depriving towns and cities in millions from cap-and-trade revenue.

February 16, 2019

Can we trust the Ford government to get health reform right?

The government’s reform blueprint is called the Connecting Care Act. Read it and you’ll be surprised by the lack of detail. We know that an uncertain number of Ontario Health Teams (OHT) will be put in place. They will be made up of health-care stakeholders — hospitals, primary care (family docs and family health teams), community-based and long-term care providers. They will provide the local input on health care across the spectrum. They will report to a new super agency, called Ontario Health.

In and of itself, this structure is puzzling. Part of the province’s rationale is to reduce bureaucracy. But in the future, instead of having LHINs, we’ll have OHTs, reporting to the new super agency, which presumably reports to the ministry of health. This isn’t a smaller bureaucracy, it’s the opposite.

December 15, 2017

The new system also collapses previously independent health agencies, such as Cancer Care Ontario, under one umbrella. But CCO is recognized as a world leader. Does it really make sense to break what isn’t broken in cancer care?

It’s also the same model Alberta has had in place for years. And health-care costs in that province have not gone down under the super agency system, they’ve gone up to a point where Alberta has higher per patient costs than any other province.

It’s not all bad news. Innovative initiatives, liked Bundled Care, which was developed at St. Joseph’s Healthcare in Hamilton, will be rolled out across the province, promising shorter hospital stays with remote support provided to patients at home.

Once it comes back from its extended summer holiday, health reform will be prominent in the news, and we’ll continue to cover and try to explain it. For Ontarians who care, and we all should, this wave of reform demands close scrutiny and robust public discussion. (Hamilton Spectator Editorial) 

 

Thursday June 13, 2019

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday June 13, 2019

Advisory council calls for $15B universal, single-payer pharmacare plan

An advisory council appointed by the Liberal government is recommending the establishment of a universal, single-payer public pharmacare system.

The council’s 171-page report, released Wednesday, calls for the creation of a new drug agency that would draft a national list of prescription medicines that would be covered by the taxpayer, beginning with an initial list of common and essential drugs, by Jan. 1, 2022.

The council recommends that initial list be expanded to a comprehensive plan by Jan. 2, 2027. When fully implemented, the total cost would be $15 billion a year.

Dr. Eric Hoskins, a former Ontario health minister and chair of the advisory council, acknowledged there are “significant incremental costs” to building pharmacare, but he noted that those costs are already being picked up by Canadians.

“We are confident that the implementation plan that we have put forward is one that meets the objectives and requirements that were handed to the council, of creating a program and implementation plan that is fair and sustainable and accessible to Canadians,” he said.

The council proposes a $2 co-payment for common drugs and $5 for less common ones. The fee would be waived for Canadians on social assistance or with low incomes.

The council spent the last year studying various pharmacare models and hearing from more than 32,000 Canadians and organizations sharing their views online and through letters, written submissions and meetings across the country.

Hoskins said it’s time to show “courage and boldness” and to do “some nation building” on a project that would benefit Canadians in “unimaginable ways.” (CBC) 

 

Tuesday March 19, 2019

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Tuesday March 19, 2019

Education changes are more and less than they seem

If you were among those who felt anxiety about the Ford government’s education reforms, you probably heaved a sigh of relief when they were finally rolled out last week.

March 13, 2019

The government made noises about changing or even killing all-day kindergarten, but ultimately ended up supporting it, at least so far. It didn’t mandate larger class sizes for early year students.

After vilifying and killing the previous government’s sex education curriculum, the government ended up restoring virtually all of the elements from the curriculum it professed to hate. The new-not-new curriculum covers most of the same ground, which is bound to make social conservatives angry, since they threw their support behind Ford’s PC party leadership in part because he pledged to kill sex-ed. But while that segment of Ford’s base must feel betrayed, students will be better served, and parents — most of whom supported the modern curriculum — will be happy with the outcome.

A “back to basics” math curriculum is also in the reforms. There are mixed opinions on that, but the fact is math scores were trending downward, so some changes are appropriate.

February 8, 2019

Then there’s the classroom cellphone ban, which is almost entirely symbolic since most school boards have local policies that are working. It’s also probably unenforceable, but if it does no real good, it also does no real harm.

Although maintaining current class size caps from kindergarten to Grade 3, Education Minister Lisa Thompson announced that an average of one student will be added to classes in Grades 4 to 8, which average high school class sizes increasing from 22 to 28. That sounds reasonable.

Not so fast. While Thompson said “Not one teacher — not one — will lose their job because of our class size strategy,” many education experts disagree. The government says any teacher reductions will be realized through retirement and attrition, but the fact remains that at the end of the rollout, there will be thousands fewer teachers in the system than there are today.

In fact, a Toronto District School Board document reveals the class sizes will mean the loss of approximately 800 high school teaching positions, along with 216 in Grades 4 through 8. The same report states that with the government’s earlier round of cuts — $25 million for special programs — 82 high school positions will disappear. Estimates are that total job losses through attrition will be between 16,000 and 18,000.

Then there’s the fact that class sizes aren’t what the seem. While the government funds for an average of 22 students, the reality is that classes often reach 30 or more to accommodate smaller specialized classes. Union officials are predicting these changes will mean class sizes of 40 in some cases.

Then there’s this. Arbitrarily increasing class sizes will lead to collective bargaining with teacher unions and boards getting off to a terrible start before negotiations even begin. In many cases local agreements include class size provisions, so unions will be fighting the provincial-controlled changes from the start.

These reforms may not be all bad, but they’re certainly not all good, and they open the door to stormy weather in our education system. (Source: Hamilton Spectator Editorial) 

 

Thursday February 7, 2019

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday February 7, 2019

Health inspections, air ambulance won’t be privatized, minister says

December 3, 2002

Ontario’s health minister was forced to make assurances Monday that long-term care inspections and the province’s air ambulance service will not be privatized, as leaked documents appear to peg those services for “outsourcing.”

Christine Elliott’s comments came after the NDP released a second set of confidential government documents following the release last week of a draft version of the Progressive Conservative government’s upcoming health-care transformation legislation.

“The NDP have intentionally created confusion about the way care is delivered in this province,” Elliott said. “As we bring forward desperately needed and overdue change to health-care in this province, Ontarians will continue to access reliable, public health-care.”

December 21, 2016

The Ontario Provincial Police have been notified about the document leaks and the person responsible is no longer employed by the government, the head of the public service said in a memo.

Both sets of leaked documents show the government is creating a health “super agency” that would be in charge of managing health services, quality improvement, patient relations, digital health and tissue donation and transplants, among other responsibilities.

The draft legislation would allow the government to roll local health integration networks, Cancer Care Ontario, eHealth Ontario, the Trillium Gift of Life Network and other government health agencies into the super agency. The local health networks are responsible for delivering home care, and one document warns of a risk of service disruptions.

Animated!

Elliott said the plan is not final and consultations are ongoing, but the NDP say the documents they revealed Monday include references to cabinet already approving the overall plan and appointing super agency board members.

One document, as part of a Dec. 13 workshop for assistant deputy ministers, references outsourcing laboratories — many of which are already privately run — inspections, licensing, devices and the province’s air ambulance service, Ornge.

Elliott said none of those services will be privatized. (Source: Hamilton Spectator) 

 

Friday February 1, 2019

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Friday February 1, 2019

1,000 Ontario hospital patients a day being treated in corridors: Report

Roughly 1,000 hospital patients in Ontario are getting medical attention in corridors instead of proper treatment spaces on “any given day,” Dr. Rueben Devlin says in his first report to Premier Doug Ford on improving health care and ending “hallway medicine.”

While the retired head of Humber River Hospital notes there is “much to be proud of” in the provincial health care system, his report found it is “too complicated” to navigate after hearing from more than 340 patients.

“People are waiting too long to receive care and too often are receiving care in the wrong place; as a result, our hospitals are crowded,” Devlin, an orthopaedic surgeon, wrote in the 32-page document titled “Hallway Health Care: A System Under Strain.”

“There needs to be more effective co-ordination at both the system level, and at the point-of-care. This could achieve better value (i.e. improved health outcomes) for taxpayer money spent,” he added. “As currently designed, the health care system does not always work efficiently.”

Animated!

One problem is people with mental health and addictions troubles often go to hospital emergency rooms when they could get better care from a family doctor or community agency, but wait too long and reach a “crisis point.”

According to one survey last year, 41 per cent of Ontarians who went to hospital emergency departments, and 93 per cent who went to walk-in clinics, were treated for conditions that could have been handled by a family physician or nurse practitioner in a primary care setting. This is often because hospitals are the only health care centre open 24 hours a day. (Toronto Star)