surgery • mackaycartoons

Thursday May 13, 2021

May 20, 2021 by Graeme MacKay

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday May 13, 2021

On Doug Ford’s watch, a new health crisis looms

A soaring backlog of surgeries and medical tests is shaking Ontario’s health-care system to its core. And Doug Ford needs a second opinion on how to deal with it because nothing he’s done so far has worked.

April 1, 2021

In struggling with the crisis unleashed by COVID-19, the premier and his government have created a new one that could result in even more suffering and death than we’ve been witnessing. Simply put, people aren’t getting the care they need when they need it.

To be fair, Ontario’s health-care system had to implement major changes over the past year as it battled the pandemic. Public health officials had to redeploy finite resources — including doctors, nurses and hospital beds — so people who had fallen sick with COVID-19 could be treated.

But three weeks ago, Dr. David Williams, Ontario’s chief medical officer of health, shifted course in a more worrisome way. He ordered hospitals across the province to halt all non-emergency surgeries and non-urgent procedures. That didn’t impact only people waiting for hip or knee surgery, it also affected people needing cancer and cardiac treatments.

Now, a rising chorus of doctors is warning Dr. Williams’ order is too restrictive. They insist the system could expeditiously treat more patients with serious medical conditions without weakening the fight against COVID-19. One of the people speaking out is Dr. Robert Nam, a Toronto surgeon who says he’s “had to turn away referrals to help patients with cancer because of the provincial order to cancel elective surgery.”

January 16, 2021

“For cancer patients waiting for treatment … their hopes of being able to beat their disease have been severely harmed by the stroke of a pen,” he added.

What makes the situation even more frustrating for Dr. Nam is that it doesn’t have to be this way. He argues hospitals have the capacity to deal with COVID-19 but also other illnesses because they’ve “developed efficiencies and surgical techniques for cancer operations that do not require a hospital bed.”

But it’s not just where the health system is today that’s alarming; it’s where the province is headed that demands immediate action. According to Ontario’s science table, the pandemic-related surgical backlog had grown to 257,000 cases as of April. As if that wasn’t bad enough, the province’s Financial Accountability Office now predicts wait-lists of 419,000 surgeries and 2.5 million diagnostic tests and procedures by the end of September.

July 27, 2019

As it stands today, people aren’t getting the timely MRI tests that might reveal a serious medical condition. And as many as 500,000 women have had their breast-cancer screening delayed. But while some of those women might have developed breast cancer, they’ll have to wait for it to be diagnosed, then treated.

Even if the health-care system can offer surgeries, tests and procedures well above pre-pandemic levels for an extended period of time, it will take the province three and a half years to clear this backlog, the Financial Accountability Office said.

Given such numbers, it’s hard to believe Health Minister Christine Elliott when she says the government is on top of this problem. While the last provincial budget committed $610 million to clear the projected surgery and diagnostic procedures backlog, the Financial Accountability Office estimates it will cost $1.3 billion to get the job done.

Somewhere, this government must come up with $700 million to deal with the systemic backlogs that are increasing by the day. Somehow, it must find the staff and resources needed to confront two separate health-care crises. And somehow, it must learn to fight a health-care battle on two fronts and at the same time. (Hamilton Spectator Editorial)

Saturday April 6, 2019

April 13, 2019 by Graeme MacKay

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Saturday April 6, 2019

Balancing Ontario’s budget about to get painful — literally

Some are suggesting the Ford government is playing a little bait and switch with recent announcements.

April 9, 2019

As in, look over here: we’re dumping the licence plate slogan Yours to Discover for something else — maybe even Open for Business. How outrageous is that? (Based on the social media reaction, the answer is: very.)

And, look, look, we’re scrapping the provincial Trillium logo because it looks like three men in a hot tub. Crazy eh?

These would be the bait parts, intended to obscure the much bigger and altogether not humorous changes, like controversial education reforms that will reduce teacher-student interaction and eventually eliminate about 3,500 teaching positions.

Or this one: the province is studying changes to OHIP that would, among other things, drastically reduce the amount of pain-control medication available to chronic pain sufferers. And funding to remove certain types of polyps found during colonoscopies may be eliminated. Diabetes management, echocardiograms and tonsillectomies are also being examined.

Animated!

And, get this, the government may defund the practice of allowing general anesthetic for people undergoing colonoscopy testing.

The potential OHIP changes, which were revealed in an exclusive story by CityNews Toronto, are part of an effort to cut $460 million from the OHIP budget. A group of doctors and government officials are examining best practices to see where medical tests are overused or unnecessary.

Having a hard look at OHIP services makes sense. Health care, overall, is the top budget item for the province ($60 billion last year), with education not far behind. It makes sense to audit what we’re doing and paying for. But going from there to legislating more uncomfortable colonoscopies is a big leap.

With the government’s first budget coming next week, we should prepare ourselves for more news like this. Even though Doug Ford denied that getting Ontario’s books in order would be a painful process, anyone with common sense knew that wasn’t realistic.

It’s all about money. Those education reforms, which the province says will make kids more resilient? How convenient that they also save a few hundred million. Same with reducing OHIP-funded services.

But keep an eye on those OHIP changes. They may also be Ford opening the door to more private health care. Want more anesthetic with that colonoscopy? We can do that for a small fee. Need more pain management drugs? Sign right here.

What about the hidden costs of cuts like these? How many Ontarians who should get colonoscopies won’t? How many pain medication patients will turn to opiates, legal or illegal? How many people with diabetes will get sicker sooner in the absence of ongoing diabetes management programs? If the government cuts psychotherapy funding to 24 hours a year — another proposal — what will happen to patients?

We know the answer. People will get sicker, faster and more seriously. They will require more expensive, intensive intervention from the health and/or social services system. Sadly, the government is probably not studying that aspect of its budget plan. (Source: Hamilton Spectator Editorial)

Saturday August 5, 2017

August 4, 2017 by Graeme MacKay

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Saturday August 5, 2017

This health-care crisis is growing

Hospitals — running over budget, operating beds they don’t have funding for. Emergency rooms — patients stacked up in hallways. Acute care beds — too many blocked, occupied by people waiting to leave hospital but with no place to go. Ambulances — stretched to the limit, often not available at all.

December 21, 2016

It’s an old story. One we would rather not argue about again. But here’s the problem. Things are not getting better, they’re getting worse. And so this old story appears here yet again in hopes it will take on a new sense of urgency.

Hamilton Health Sciences needs to cut $20 million from its budget, St. Joseph’s Healthcare $7 million. In both cases, staffing will be affected, stretching already thin human resources even thinner. Executive staff are being cut as well as front line. In the case of HHS, three senior executives are leaving. And that’s at a hospital system that already spends below the provincial average on administration, according to the Canadian Institute for Health Information. HHS spends 4.9 per cent on administration, higher than the national average of 4.3 per cent but well below the provincial average of 5.6 per cent. Keep that in mind next time someone declares hospitals would be fine if only they cut senior management costs.

May 10, 2016

Hospitals have seen provincial funding cut repeatedly. The province provided some relief this year with a two per cent increase. That doesn’t even cover inflation.

That’s why it’s so frustrating when Health Minister Eric Hoskins says he doesn’t expect funding to impact patient care. What world do Hoskins and other politicians live in? It’s already affecting patient care. In Ontario, you’re not supposed to spend 48 hours on a bed in a hallway awaiting admission. You shouldn’t expect to wait double-digit hours in the ER. You shouldn’t expect to be told there’s no acute care bed for a sick relative. You shouldn’t expect years-long waiting lists for aging relatives waiting for long-term care. All these are happening and getting more common. (Source: Hamilton Spectator Editorial)

Wednesday December 21, 2016

December 20, 2016 by Graeme MacKay

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Wednesday December 21, 2016

Ottawa, provinces fail to reach a deal on health spending

Ottawa and the provinces have failed to reach a deal on health-care funding, despite a $11.5-billion pledge by the federal government to boost targeted spending on home care and mental health.

The federal government has now taken that offer off the table, Finance Minister Bill Morneau said Monday, and the Canada Health Transfer (CHT) spending increase will revert to 3 per cent a year as of April 1, 2017.

Morneau had told the provinces he was willing to grow that key federal transfer by 3.5 per cent each year over the next five years — at a value of roughly $20 billion — but the provinces balked.

“We came to the provinces with a significant offer of funds … We’re disappointed we weren’t successful,” Morneau told reporters.

Jane Philpott, Canada’s health minister, said the federal government’s money could have made a real difference in the lives of many Canadians.

“I woke up this morning feeling very hopeful, thinking about half a million kids that are waiting for care for mental health services and hoping to be able to give them good news today,” she said.

“We’re disappointed that the provinces and territories did not feel like they could accept this offer and that they couldn’t find ways to use these resources immediately, to be able to get care out to Canadians.”

Ontario Finance Minister Charles Sousa said while the provinces rejected the federal funding plan, it was Morneau who was responsible for ending the meeting early.

“There was an urgency to close the meeting off. We’re here, we desire an agreement, we need to come to a conclusion. Why have anybody attend if there’s nothing to negotiate or discuss?” Sousa said, adding Ottawa wasn’t willing to listen to evidence that its proposed funding plan would imperil the country’s health-care system. (Source: CBC News)

Wednesday May 9, 2012

May 9, 2012 by Graeme MacKay

By Graeme MacKay, The Hamilton Spectator, Wednesday May 9, 2012

Lower fees forced on Ontario doctors

Sending a signal that will reverberate throughout Ontario’s broader public sector, Dalton McGuinty’s Liberals have broken with their conciliatory past by forcing a tough new deal onto Ontario’s doctors.

Less than two weeks after negotiations with the Ontario Medical Association fell apart, and despite requests by the OMA to call in a conciliator, Health Minister Deb Matthews announced Monday that a package of cuts to doctors’ fees will be unilaterally imposed through regulations, retroactive to April 1.

The abrupt manner in which the cuts were unveiled, amid claims by the OMA that Ms. Matthews has misrepresented discussions at the bargaining table, sets an aggressive tone for other negotiations – including with the province’s teachers. And it epitomized the shifting focus of a government once known for its big-spending ways.

The 37 fee-schedule changes announced Monday focus heavily (although not exclusively) on a relatively small number of high-paid specialists – mostly radiologists, ophthalmologists and cardiologists – and by the Liberals’ estimate will save $338-million in 2012-13 and $440-million in 2013-14. But sources say there are more broad-based cuts to come, to get the rest of the way to a two-year freeze in doctors’ total pay envelope.

Still on the table is the elimination of a “retention bonus,” which the Liberals had brought in to dissuade doctors from leaving the province. That benefit currently peaks at $5,000 every three years for doctors who have practised at least three decades.

The government also wants to revive so-called clawbacks of doctors’ fees once they exceed a level at which their ratio to overhead costs becomes skewed. (Source: Globe & Mail)