Health Action Assemblies:
Thunder Bay - Approximately 40 people participated in a community meeting that set local action plans to deal with hospital cuts and privatization, long term care, homecare and the new LHINs. Discussion was lively and in-depth. Local lobbying and follow up activities were planned.
Kingston - Over 60 people participated in the assembly. Participants broke into strategy planning groups on hospital cuts, homecare and long term care. Follow up actions are underway.
Kitchener-Waterloo - Well over 200 attended a large community forum on federal and provincial health issues. Federal NDP leader Jack Layton gave an impassioned speech about challenges to the Canada Health Act and the threat of privatization. Natalie Mehra from the OHC reviewed provincial health restructuring plans. Local care providers gave eloquent presentations about privatization and threats to local health services. A revitalized local health coalition was created and future planning was started.
Upcoming Events Cross-Ontario
Kingston - Town Hall Meeting on Hospital Cuts - May 5, 7 pm at Regiopolis-Notre Dame Secondary School. Panelists: Cathy Dunne, President & CEO Providence Continuing Care; Hugh Graham, ED Hotel Dieu Hospital; Joe de Mora, President & CEO Kingston General Hospital; John Gerretsen MPP invited; Natalie Mehra,OHC.
Lindsay – Health Action Assembly. The Lindsay coalition is planning an assembly for June. Date and TBA. For more information, please contact new coalition co chair Deborah at 705-878-4063.
Petrolia – Town Hall Meeting on Hospital and Health Restructuring, Victoria Playhouse Theatre, 1:30 – 3:30 pm May 14. Hospital CEOs, MPPs and MPs invited.
Richmond Hill - Town Hall Meeting on Hospital Cuts - May 26, 7 pm at Fontana Gardens, 7400 Keele St (at Hwy 7). York Hospital President & CEO invited.
Timmins - Long Term Care Forum - May 19, 7 pm at Knights of Columbus Hall in Iroquois Falls. Panelists: CEO of Golden Manor Public LTC Facility and member of Ontario Association of Non-Profit Homes and Services for Seniors; Jagger Smith, Intern at FedNor; CEO of South Centennial Manor, Non Profit LTC Facility and Natalie Mehra OHC.
Windsor – Over 60 people came out in an April snow storm to join in a day-long assembly. Participants created action plans for the hospital budget cuts, LHINs and de-listing. The local coalition continues to show leadership with its protests of the OHIP delisting.
LHINs Forum:
Toronto - Over 90 people attended a community forum on the province's new plans for Local Health Integration Networks. Panelists Michael Rachlis and Natalie Mehra reviewed the experiences with regionalization in other jurisdictions. Dr. Rachlis gave examples of innovation to improve health services within the public health system. A lively question and answer session followed the panel. Participants agreed to create shadow LHINs to ensure democratic protection of the public health system as well as to create a resolution for groups to discuss.
Town Hall Meetings on Hospital Cuts:
London - A packed community gathering of 170 heard presentations from the OHC along with 3 MPPs and St. Joseph's hospital CEO. An emotional question and answer session followed.
Peterborough - Over 200 attended this town hall meeting along with the MPP and hospital CEO. The crowd used the opportunity to ask the panelists about service cuts and plans for the new local hospital.
Sarnia - 75 people and local MP engaged in a lively discussion about hospital and health care restructuring at this community meeting. Participants agreed to push MPPs and hospital CEOs to come out for another town hall to discuss plans for regional health services and hospital budget cuts.
Homecare Public Forum:
St. Catharines - An afternoon session including 50 community members engaged in a vibrant discussion about the effects of competitive bidding. Participants welcomed a sneak preview of the OHC review of the effects of the bidding system. A local action plan was adopted.
P3s Public Forum:
Toronto – Over 150 people got together to discuss the threat of privatization for three of Toronto’s downtown hospitals. An evening with MPP Marilyn Churley, John Campey from the Metro Social Planning Council, John Cartwright of the Toronto Labour Council and Natalie Mehra of the OHC, inspired door-to-door blitz canvassing reaching over 1,000 households in the downtown riding of Health Minister George Smitherman.
Inside This Issue: New Reports on P3s and Homecare – Coalitions Across Canada Fight Back Against Klein, Private Clinics and P3s – Queen’s Park Watch: What’s Up – Letters and Responses.
Cross- Canada Updates
Alberta Coalition Pre-empts Klein’s Privatization Symposium
The Alberta “Friends of Medicare” will be co-hosting a conference in Calgary, April 30-May 1 entitled “Weighing the Evidence: International Experience with Health Care Reform”. This conference is timed to pre-empt the claims for a “third way” in health care delivery being touted by Ralph Klein’s Government in its May 3-5 Conference which is also in Calgary.
Premier Klein’s conference is a blatant attempt to distract Canadians from the example of private health care in the United States. “Weighing the Evidence” will be an important counter-balance to the claims made by the proponents of privatization through this “third way”.
Health care experts and economists from across Canada, UK, Australia, France and the United States will be in Calgary this weekend for “Weighing the Evidence”. I will represent the Ontario Health Coalition at the conference and will write a report for the next edition of “The Pulse”. From Dora Jeffries, co chair, OHC
BC Nurses Take Private Clinics to Supreme Court
In a petition filed in BC Supreme Court today (April 21), the BC nurses call on the government to audit the books of private clinic operators and require they pay back all patients who have been illegally charged extra fees for procedures that are covered under medicare. The nurses allege the government has failed to enforce that provincial statute which is in place to ensure compliance with the Canada Health Act. In examples cited in the court petition, physicians were paid by the provincial Medical Services Plan for services they provided in private clinics, but the patients were then billed several thousand dollars for the same procedure by the private clinics as a “facility fee”. In other cases the petition cites evidence of possible breaches in public statements by certain clinic operators. Clinics named in the petition are McCallum Surgical Centre, Pezim Surgical Centre, False Creek Surgical Centre and Cambie Surgical Centre.
Montreal Protesters Shut Down P3 Conference, Force Cancellation Minister’s Speech
More than 200 activists from all of Québec's labour
centrals shut down a conference of the Canadian
Council on Public Private Partnerships (C2P3) – the
business lobby group pushing P3s. The conference
was on P3s in the health care sector, Mar. 23.
On March 14, protesters dressed as business executives forced Treasury Board President Monique Jerome-Forget to cancel a speech to the Canadian Club. The protesters, who bought tickets to the event, waited until the Quebec cabinet minister was about to begin speaking. They then got up and began shouting "No to PPPs". The demonstrators belong to a coalition called J'ai jamais vote pour ca (I Never Voted for That), which is opposed to Premier Jean Charest's plans to privatize public services.
Canadian Health Coalition Briefs
Mike McBane of the Canadian Health Coalition has presented two briefs this week on the issue of food safety: "Bill C-28 + Smart Regulation = A nasty business" to the Standing Committee on Health, and; "Bill C-27: Rewarding Failure" on the Canadian Food Inspection Agency Enforcement Act to the Standing Committee on Agriculture. Both are posted on the CHC website at www.medicare.ca
OHC Releases Two New Reports
100 P3s: flawed, failed, abandoned
The report details a litany of cost overruns, legal disputes, bankruptcies, environmental disasters, and shoddy construction in Canada and abroad. Some examples include:
100 P3s: flawed, failed, abandoned
- Abbottsford, British Columbia: costs for the planned P3 hospital have increased from $210 to $424 million.
- Calgary, Alberta: The Calgary Health Region recently cancelled plans for a P3 hospital. Ralph Klein was forced to pull back a proposed P3 courthouse when costs skyrocketed from $300 to $500 million and the flawed design met the needs of the developer, but not those of the justices.
- Maple Ridge, British Columbia: a downtown redevelopment P3 deal was cancelled after the community voted to dissolve the P3 contract. The move has saved taxpayers between $9 and $11 million.
- Quebec City, Quebec: A government-commissioned study has found that a proposed P3 long term care facility will cost $14 million more than it would to build the facility publicly.
INTERNATIONAL P3s FLAWED, FAILED OR ABANDONED:
- Edinburgh, Scotland: The high costs of the P3 have been born by reducing beds in a false estimation of patient "throughput". Beds have been reduced by 24% across the health district and community services have also been cut. Further cuts may be required to meet the hospital deficit, primarily due to the high costs of the P3s.
- La Trobe, Australia: The Victoria government had to buy back the hospital from the private company after the consortium lost $10 million and announced it was suing the government.
- London, England: The London Underground P3 has added 455 million pounds to the cost of the subway project, according to a report by the National Audit Office. Costs for the contracts rose by 590 million pounds through the negotiation of the contract and the project was more than two years behind schedule. The Paddington Hospital P3 costs have increased from 360 million to 800 million pounds.
- United Kingdom: The Network Rail P3 was re-publicized after faulty maintenance resulted in a rail crash that killed seven people and injured 76. The contract has been plagued with lengthy legal disputes.
- Norfolk, England: A P3 contract for 6 schools in Norfolk collapsed as P3 company Jarvis, facing financial difficulties, was 26 months behind schedule and was unable to find a local subcontractor.
Market Competition in Ontario’s Homecare Sector: Lessons and Consequences
In response to large protests in Ottawa, St. Catharines and Toronto, the Ministry of Health and Long Term Care has conducted a review of the competitive bidding process in homecare. In our meeting with Elinor Caplan, appointed to conduct the government’s review, Ms. Caplan made clear to the Ontario Health Coalition that her mandate is limited to a review of “procurement procedure”. The system of “managed competition” or competitive bidding, introduced by the former Conservative government, will not be reviewed and will remain in place, despite the Health Minister’s announcement.
The structure of Ontario’s homecare system is a touchstone issue for organizations concerned about protecting public healthcare. Homecare is one of the fastest growing health sectors, used by successive governments to move patients out of hospitals more quickly. Competitive bidding in homecare has ushered in a number of for-profit corporations that now control the majority of market share at the expense of non-profits that provided services for decades. The culture of the sector has changed markedly since the introduction of the private market. By adopting a long-term strategy to continue competitive bidding, the Liberal government has excluded the possibility of homecare becoming a public service and has signaled its acceptance of long-term privatization. This report details the consequences of market privatization in homecare.
Both reports are available OHC website or by calling the coalition.
Letters
To: OHC
I am the Manager of Community Support and Volunteer Services at VON Durham. I just read the report on the RFP process for homecare contracts-BRAVO! Thanks so much for mentioning all of the VONs who lost their contracts. I was saddened, however, that VON Durham was not mentioned. We too lost two RFP's in 2004-one for community nursing and one for mental health nursing. We lost close to 100 staff members between nurses and office support staff when Care Partners and VHA (neither of whom had a Durham office!) took over our community nursing contract and St. Elizabeth took over our mental health contract.
One point that was not made in your report is what happens to the agencies like ours who have community support programs that struggle to continue after the loss of most of the agency's revenue. This results in higher operating costs resulting in higher unit costs-thereby jeopardizing these programs as well.
I am sure that you share my frustration when you see how much money could be saved by allowing the not-for-profit agencies like VON who have been in Canada for over 100 hundred years to focus on serving the needs of the community instead of trying to figure out how branches that have lost contracts can remain open. It is ironic that VON actually invented homecare and its best practices in this country, and this is how we are rewarded.
Keep up the good work-may your message be heard loud and clear by those who need to hear it.
NANCY HUGHES, HSC,SDC,Cert. Manager, Community Support & Volunteer Services
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To the OHC
I am disappointed that the report did not look at professional services other than nurses when analysing the effects of ‘seamless” change over of contracts to the lowest bidder.
In Ottawa there was a 100% lay off of professionals (Occupational therapists, Physio, social workers, dieticians etc) when the unionized company lost its bid to non-union agencies (VON and COTA) about 20% of professionals lost their jobs and the rest had to re-apply to the successful bidders for jobs they had been doing for years. They were re-“hired” at a 30% pay cut which included lower wages, drastic cut in benefits and holidays and no seniority. Professionals have lost heart and feel that this most challenging of professional work places (in clients’ homes) is now under paid and not appreciated. Long time experienced workers are leaving and newer professionals look on this work as entry level jobs until they can find something with more stability.
Your report has ignored the smaller but significant group of allied health professionals and the impact which competitive bidding process has had on this service which shortens patient stay in hospital and keeps people in their own homes by providing maintenance in the community through CCAC referrals.
BEVERLEE MCINTOSH, Ottawa Council of Women Health Committee
Leisureworld Sold to Hwy 407 Company
Macquarie Bank of Australia is attempting to buy Leisureworld for $528-million. The deal will cover more than 3,200 nursing and retirement home residents in Ontario. It is still subject to government approval. Macquarie Infrastructure Group – a fund of the bank – is in a legal battle with the government of Ontario over tolls on Highway 407. Source: Globe and Mail, Tuesday March 22, 2005.
LHINs Bogged Down
The announced date for the appointment of the first 28 directors – two for each LHIN – has come and gone with no word from the Ministry of Health. Reportedly, the Ministry has had trouble getting applications for the positions from qualified applicants. New timelines have not yet been released.
OHC Updates
Welcome to Our New Co Chair!
Dora Jeffries, past recipient of the Daniel Benedict Award for Health Care Activism, has been elected as the new community co chair for the Ontario Health Coalition. Dora is known to local coalition members as the former co chair of the Brampton Health Coalition, working relentlessly on the fight to keep the Brampton hospital public and stop the P3. Dora is a retired teacher, mother and brings a wealth of experience and energy to the position. Welcome Dora!
Thank You to Ethel Meade!
Ethel Meade, one of the founding Administrative Committee members of the Ontario Health Coalition is retiring as the community co chair. Ethel has long been active in many seniors' organizations including the Older Women's Network, CareWatch Toronto, and the Ontario Coalition of Senior Citizens' Organizations. Ethel is moving on to co chair OCSCO. The Ontario Health Coalition extends Ethel a warm thank you for her hard work, commitment, and expertise. Our best wishes to Ethel in her new position.
New Resources for Coalition Members
We have been busy updating fact sheets, briefing notes and creating new reports to deal with the flurry of activity at the Ministry of Health. Here are a few new resources available from the OHC:
o New Updated Fact Sheet on the P3s
o New Fact Sheet on Hospital Restructuring & Budgets
o New Report on Competitive Bidding In Homecare
o New Report on 100 P3s: Failed, Flawed and Abandoned
o New Analysis of LHINs
All are available on the OHC website or by calling the office.
Internet Connections & Activism
LHINS-l email listserve to share intelligence & information.To join email ohc@sympatico.ca and write "subscribe LHINS listserve".
homecare-l listserve to share information about the impacts of service-contraction and competitive bidding. To join, email: homecare-l@list.web.ca and type "subscribe homecare-l" in the subject line.
P3 Watch listserve, to share information about P3s across the country. To join, please email ohc@sympatico.ca and type "P3 listserve" into the subject line.
Private Hospitals and Superbugs
A new report details the rising incidence of superbugs in British hospital, connecting them to staffing cuts as a result of privatization. Britain now has the European Union’s second worst rate of infection for MRSA – a serious hospital acquired infection. Deaths from MRSA have increased 15 fold, and infection rates 24-fold, according to the UK’s Office of National Statistics. There were 5,309 infections in 2002.
Klein, Harris, Manning and Fraser Institute On New Privatization Crusade
Mike Harris is back, along with a crew of the usual suspects in a country-wide campaign designed to re-open the debate on privatization closed by Roy Romanow. Coalitions are gearing up to fight to protect universal health care. Harris and Manning have released a new report for the Fraser Institute calling for a range of devolution and privatization. In a recent media initiative, Klein likened the Canada Health Act to a “dusty old rule book”. The CanWest media group – including the National Post, Global TV and others – has taken up the campaign.
Worth Repeating
Kingston Health Coalition Responds to Media Coverage of Fraser Institute Campaign
Dear editors,
Your paper recently ran a report of new research done by Can-West Global TV that found that France, and a few other European countries, had lower health care costs than Canada, no wait times and private delivery.
Unfortunately, the information is neither new nor research in any meaningful sense. The Fraser Institute, a right wing institute with principles like Preston Manning and Mike Harris, has been spouting the benefits of these mixed European health systems for a while. Romanow looked into them, and rejected them, and now Premier Klein is making France part of his new push to undercut the Canada Health Act.
While it is true that France does have some for-profit health delivery, and easy access to most services, it health system total costs are comparable but not lower than Canada’s.
What the report left out is more important. France is able to keep its health costs down by paying its health care workers, especially physicians and nurses significantly less than what they make in Canada. In essence, what France does is take money from health professionals to fund for-profit health care and overcapacity (inefficiencies) in its health system.
France’s health system also runs multi-billion dollar yearly deficits. To try and take control of its excess health expenditures, France has recently introduced rules forcing citizens to sign up with one doctor and restricting the access to specialists.
The Fraser Institute while touting the for-profit delivery used in France is arguing that our doctors get paid too little and they need an increase. They can not have it both ways. If we both paid doctors more and paid for the extra cost of for-profit healthcare, we would have a truly unsustainable health care system. Really, the Fraser Institutes main interest is in making more money for private healthcare corporations; the rest be damned.
Our public health care system works pretty well in spite of this sniping from Klein, Harris, Manning and Can-West Global. We are taking some of the steps needed to make the system better. It is too bad we have to keeping fighting this rear guard action against self-serving ideas that were debated and rejected years ago.
Ross Sutherland.
Chair of the Kingston Health Coalition
Ontario Health Updates
Health Minister Makes Clearer His Restructuring Agenda at World Health Day Speech
On April 7, the Health Minister made a speech at the Rotman School of Management, University of Toronto. The speech was standard – a list of initiatives and achievements from the Health Ministry. But in the brief question and answer period the minister made quick mention of a few major policy directions under way or being considered. Here are some notes from the speech:
Re. potential closure of local services:
The Minister stated that Hugh McLeod had helped to identify "low hanging fruit" ie. waste in the health system. Smitherman noted that there was lots of "low hanging fruit. He said that the tertiary hospitals in Toronto are doing lots of work that doesn't belong in their hospitals. He said that the cataract surgeries would soon be moved out to a clinic. He also used an example of hip or knee replacement surgery and noted that improvements in technology could be better done across 20 hospitals, rather than the 57 that currently do the surgeries. He also stated that there are more than 600 community mental health agencies providing services across the province and there is currently little way to assess whether people are getting necessary services or falling through the cracks.
Re. potential "efficiencies"
He noted that hospitals are now competing by bidding for surgeries. The minister believes that the range of costs exposed through this process showed the inefficiencies in hospitals, ditto for the cost of providing MRIs. He noted with pride the first example of government bulk purchasing for MRI equipment, which has saved millions.
Re. the LHINs
He said that the LHINs first 28 directors (Board members) would be appointed later this month.
Upcoming Legislation and Reports
The new Long Term Care Act is expected to be introduced this legislative session. So far, it has not been scheduled. We will keep you posted.
Elinor Caplan’s Homecare Review was due on April 1. To date it has not been released.
The 10 Year Infrastructure Plan for Ontario was supposed to be released last fall, according to remarks by Minister David Caplan in a press conference last July. To date it has not been released and all P3 planning remains secret.
The LHINs first 28 directors were supposed to be appointed by April 1. This deadline has not been met. Recently Health Minister George Smitherman stated that the appointments would be made later in April. We will keep you posted.
The provincial budget is expected in early May. To date, the schedule has not been announced. We will keep you posted.
SARS Interim Report Released
The interim report, released earlier this month, contained many recommendations to streamline emergency response and ensure adequate resources and staffing in the event of another health emergency. Among the recommendations:
- the province must decide whether or not to upload public health from municipalities
- all healthcare staff should have whistleblower protection
- infectious disease report should be strengthened
- the decision-point in the case of health emergencies must be clarified
- unpaid leaves should be allowed for those in quarantine and for their caregivers
- those who perate with quarantine orders should receive compensation.