Newsletter of the Ontario Health Coalition
What's Inside
1. Across Ontario: Actions & Events
2. The Latest: News & Updates on P3s, MRI/CT privatization, Drug Patent Review
3. Accountability or Deception? National Health Council: An Open Letter to the Prime Minister
4. Dismantling 100 Years of Non-Profit Homecare - new fact sheet
5. Listen Up! Women and the Future of Medicare - toolkits and report available
6. Resources & Reports: new fact sheets, releases and reports available
Thousands Are Taking the Pledge!
Communities gear up for the election
This spring, the Ontario Health Coalition launched a mass pledge campaign calling for voters to commit to supporting only those candidates who will make clear promises to strengthen public Medicare and stop for-profit healthcare. Across Ontario, health coalitions, church groups, unions, and social service organizations are signing up people in the thousands. Local politicians are feeling the pressure. For a quick update on campaign events across Ontario see below.
Stopping Private For-Profit Hospitals
Mounting a Stiff Resistance to P3s
The provincial government has announced its intention to build for-profit (public-private-partnership or P3) hospitals in Ottawa, Uxbridge, Markham-Stouffville, and Brampton. Most recently, workers at the Centre for Addiction & Mental Health in Toronto learned that their hospital is planning to redevelop as a P3 also. Health coalitions and activists have been working ceaselessly to create community debate about these schemes. Last month, cross-province cavalcades and rallies drew attention to the issue. A series of press conferences revealing corporate donations to Conservative MPPs, decrying the secrecy that surrounds the deals, and releasing the record of the P3 hospitals in other countries have successfully garnered media attention. Tons of events are ongoing in communities across the province. For an action update, see pp 2 -5. For the latest news on P3s see pp 5. For a information on a new fact sheet & video see pp 8.
Poaching from the Public for Profit
The Latest on Private MRI/CT Clinics
Upcoming: In the September issue of "The Pulse" look for the platform review of Ontario's political parties & questions for municipal election candidates.In response to the provincial Conservatives' introduction of for-profit MRI/CT clinics, the Ontario Health Coalition has held several media events looking at the evidence of private clinics poaching physicians and technologists from hospitals. A full report on these clinics will be released in the fall.
For information that has been released to date, see MRI media releases at www.ontariohealthcolation.ca
Across Ontario: Actions & Events
"
When people find out what's happening they are very angry. The contact with people is so critical"Dora Jeffries, co chair, Brampton Health Coalition. 45 members of the coalition have been going door-to-door in their community reaching thousands of households to talk about the provincial Conservatives' plans to privatize their hospital.
Brampton:
The Brampton Health Coalition recently held a press conference at Queen's Parkto expose the provincial government's secrecy regarding the plans for a P3 hospital in Brampton. Lots of media attention resulted. A cavalcade and rally of over 100 people featured a corporate piggy race through red Medicare ribbon to a trough and ended in a visit by coalition member to Conservative MPP Joe Spina's office. A community launch of the P3 video garnered excellent local coverage. The coalition also arranged an excellent article on the proposed P3 hospital in the local business newspaper. Coalition members met with Health Minister and Brampton MPP Tony Clement who, despite promises, has still not provided key information on the local hospital privatization. An editorial meeting with the local paper has improved coverage. A few weeks ago, the coalition hosted a public meeting with Argentinian health care worker and activist Dora Martinez who discussed health privatization in Argentina and the threat to public health care posed by international trade regimes. Most recently, this incredibly active coalition has been conducting a door-to-door blitz that reached thousands of households to build opposition to the proposed P3 hospital.Burlington:
Members of the Burlington coalition travelled to Toronto to join in the march and rally against for-profit hospitals and clinics. The coalition has been lobbying federal MPs on the drug patent review that is currently in process. In addition, they have put together questions and plans for an all-candidates' meetings in preparation for the provincial election.Cloyne:
A public meeting on healthcare featuring the OHC, the Kingston Health Coalition and the Kingston Council on Aging, was held in Tamworth to a very appreciative reception from local residents. A petition to save the VON and the coalition postcards have been circulated through the communities in Lennox and Addington."People are beginning to see that there is
more to life than tax cuts"
Burlington Health Coalition co
chair David Goodings
Cornwall:
The coalition planned a fabulous day of music and politics in a busy waterfront bandshell called "Rock the Vote". This day-long event features a number of bands interspersed with speakers and attracted hundreds of young people who were asked to sign pledge cards and listened to speeches about Medicare and other topics between bands. Tons of postcards have been signed and sent in and the P3 video press conference received excellent media coverage. A public meeting to screen the video is in the works for the fall.Guelph:
The coalition organized a cavalcade through the city that garnered tons of public and media attention. Market stalls held every other Saturday have yielded hundreds of signed pledges and will continue through the summer. Health coalition members have been ? active, speaking to numerous community groups on privatization and other health issues and meeting with local candidates on P3s prior to the election. A public forum is planned for September featuring Dr. P.J. Devereaux.Kenora:
The coalition staged its first-ever demonstration at Liberal MP Robert Nault's office to protest the looming privatization of Canada's health system and demand implementation of the Romanow Report. They also held a large rally in Kenora and have been actively distributing pledge cards at the mall. This coalition has garnered great media coverage for its events.Kingston:
A successful media conference revealed information about Kingston's planned for-profit MRI/CT clinic that threatens to poach scarce technical staff from the local hospital. A successful caravan against health privatization traversed the city to hoots of support from passing motorists. The coalition held a media conference to release the P3 video, and over 60 attended a public screening. Local municipal and provincial politicians came to learn about the projects and to answer questions about their position on the projects. The coalition has been busy writing in the localpaper and to politicians about the Victorian Order of Nurses' closure of home nursing services in North Frontenac, Lennox & Addington due to inadequate funding and privatization. Local activists have taken dozens of videos out to community organizations churches and agencies' meetings to spread the word about P3s."It feels good that we're letting all
those people know what's happening.... I'm getting a thrill out of seeing their
reactions. Education really works!"
Oxford coalition
co chair Violette Thibodeau.
Kawartha:
A recent well-attended public meeting in Bobcaygeon led to some good media coverage and a lively discussion. The P3 video was screened publicly and pledge cards are in process. Local activists have taken P3 videos out to show to communityOshawa:
Busloads of seniors and others travelled to Toronto for the rally against P3s. Thousands of pledge cards have been collected in Oshawa and the campaign was a hit at a recent retirees' picnic. The P3 video has been released. A farmers market stall and barbeque are in the works - delayed due to the local SARS scare.Ottawa:
The Ottawa Health Coalition has been busy preparing material on homecare for local all-candidates' meetings. A very successful media launch of the P3 hospital video served to heat up an already vigorous debate in the local newspapers about the proposed for-profit redevelopment of the Royal Ottawa Hospital. Local activists have been phoning and writing to MPs to attain input into the current drug patent review.Oakville:
A new coalition is just starting up in Oakville. The coalition's first events will take place in September.Oxford:
Joining the cross-province events to stop the for-profit hospitals and clinics, a lively caravan wound its way through the city beeping in protest outside the Bank of Montreal (one of the bidders for the private hospitals). The decorated cars and motorcycle were a hit with local residents who came out of buildings to watch or honked their horns to signal support. The Oxford Health Coalition has also held several public information booths, including a very successful pledge sign-up and barbeque in Ingersoll on May 31. A recent press conference successfully garnered attention as the coalition helped to release a videoon P3 hospitals. Plans are in the works for door-to-door canvassing and a public screening of the P3 video."Marching in the Canada Day parade was
terrific. Thousands of people saw the Medicare banner, and you could tell that
they appreciated it. It reminds us of why we do what we
do."
Roy Brady, Peterborough
Coalition
Peterborough:
The coalition marched in the Canada Day Parade with their big Medicare banner to a very appreciative response. Four meetings have been held with the local MP, most recently on the drug patent review Planning is complete for an all-candidates' meeting on healthcare - ready to go when the election is called. The coalition has also done a great job of researching the redevelopment of the local hospital, staying in contact with the CEO and ensuring the hospital remains in public non-profit control. The P3 video was released to the media in press conferences in Peterborough and Cobourg. In the fall, the coalition plans a Cogeco cable show on P3s and a public meeting to screen the video .
Renfrew:
The P3 video has been released to the media in Renfrew and Pembroke. In addition, a public meeting featuring the video has been held. The coalition is working to ensure healthcare is one of the top priority issues in the upcoming election through excellent media coverage.St. Catharines:
An excellent campaign launch featuring local municipal and provincial politicians signing the pledge to support public Medicare was held. A banner supporting public Medicare signed by local politicians has been hung across the busiest intersection in the city. Several pledge signing booths in the market square have garnered lots of signatures. The local labour council has passed a resolution to ensure that the two new hospitals planned for St. Catharines are built with public funds and will remain in non-profit community control. A media conference to launch the P3 hospital video was held. The coalition was a hit at a seniors' event last week as participants lined up to sign the pledge. A public meeting is planned for September.Sarnia:
The coalition has held a press and public release of the P3 video. Upcoming action plans were discussed, including participation in the "Healthy Communities" initiative, an all-candidates' meeting and upcoming door-to-door canvassing. The coalition is also planning a 1? day public forum in the fall.Sudbury:
Lots of media attention ensued from the P3 video release with concern expressed about future plans for Sudbury's hospital redevelopment. The local labour council also showed the video and discussed the privatization issue.
Timmins:
The local P3 video release yielded excellent media coverage. A public screening of the video was followed by a good discussion. A distribution strategy has been set for the pledge card campaign as the coalition gears up for the election.Toronto:
Pledge cards have been distributed widely through non-profit organizations and are flooding into coalition offices. The coalition played a critical role in organizing and building for a large rally and march against the private hospitals and clinics. Most recently, over 30 people attended a public meeting with Argentinian activist to talk about health privatization. A well-attended barbeque at the Centre for Addiction & Mental Health to expose the proposed P3 redevelopment of that hospital was organized by the unions at the hospital in partnership with the health coalition.Windsor:
A large rally against P3 hospitals followed by a march to the river was a feature of the coalition's campaign this spring. A P3 video press conference was held and pledge cards are in the works.News & Updates
P3 Update
Although there are still only four P3 hospitals announced publicly by the provincial government or by hospital executives, there are more in the works. Officially announced are P3s in Brampton, Ottawa & Markham-Stouffville. The Uxbridge cottage hospital is seeking provincial approval to redevelop as a P3. Most recently, the unions representing healthcare workers at the Centre for Addiction and Mental Health in Toronto have learned that their hospital is pursuing plans to redevelop as a P3. Concerns have been expressed about the hospital redevelopments in Sioux Lookout and Sudbury. Hospital redevelopments are planned in Cornwall and St. Catharines without any sign that the provincial government will provide public funding for them. If you know of P3 plans in your community, or if your local hospital has redevelopment plans without clear public financing, let us know so we can track what is happening.
No lease deals have been signed yet, but details of timelines appear to be under a news blackout. In Brampton, the preferred bidder has been chosen and negotiations apparently have begun. In late May, the Ottawa Citizen reported that the hospital was just weeks away from announcing the preferred bidder and has approved the design of the new hospital but the anticipated announcement of the finalist bidder has not yet happened. The hospital has also revealed plans to forge a deal to raise money from the hospital lands but have not said what kind of sale or lease of lands they intend. The hospital has also revealed to Ottawa newspapers that the lease deal with the developer will be 66 years and for the building will be 24 years. In Uxbridge, approval has not yet been given by the province but the plan is to bring the local proposal under the umbrella of Markham-Stouffville's P3 expansion which is already approved. This proposed amalgamation has not received the provincial government's nod as yet. Despite promises last fall that the hospital board would not privatize any services, the amalgamation would likely mean that the Uxbridge proposal will end up the same model of P3 as all the others and include the privatization of services as part of the deal.
groups.Drug Patent Racket
Drug costs are the fastest growing expense in Ontario's health system - increasing by a whopping 130% since 1995. Challenges are mounting to drug patent laws that feed profit to transnational pharmaceutical corporations while millions are unable to afford the medications they need. One practice is called "evergreening" in which the corporations extend their patents even after the 20 year initial period expires by making very minor changes to the drug to keep cheaper generic drugs off the market for longer. The Canadian Health Coalition and allies have applied for a review of this practice by the Competition Bureau. Meanwhile, the Parliamentary Industry Committee, has avoided reviewing the drug patent issue under pressure from the pharmaceutical industry which has close ties to the federal government. Community pressure forced a set of hearings from Jun 2 -4 but public and advocacy groups were not allowed standing. The committee says it plans to grant hearing to public and advocacy groups in the autumn. For more information see the Canadian Health Coalition website at www.healthcoalition.ca.
And in other news.....
* US companies are forcing employees to take the burden of soaring prescription drug costs. A recent New York Times article notes that health plans are imposing deductibles of as much as $150, employee co-payments for drug plans are increasing and some plans are paying for certain expensive drugs only if a doctor first tries a cheaper treatment then petitions the health plan for approval.
* New Brunswick Premier Bernard Lord has announced his intention to build a P3 hospital in that province.
* Premier Gordon Campbell of B.C. has introduced new fees for drugs, closures of long term care facilities, massive hospital staff layoffs and privatization. Most recently his government is planning privatize over 200 types of surgeries. In mid-June a for-profit eye surgery clinic was impounded by bailiffs for over $10,000 in unpaid back-rent in a brutal lesson about reliance on for-profit businesses to provide necessary health services.
This open letter regarding the Romanow recommendation for a Health Council to monitor and report on health spending and outcomes was released on July 9, 2003. The provincial premiers were meeting in Charlottetown at that time to discuss the Health Council, among other matters.
Ontario Health Coalition
15 Gervais Drive, Suite 305, Toronto, Ontario M3C 1Y8
Phone (416) 441-2502 Fax (416) 441-4073 email ohc@sympatico.ca
Open Letter
July 10, 2003
To: The Right Hon. Jean Chretien, Prime Minister & The Hon. Anne McLellan, Minister of Health
We are writing to express our deep concern about reports of delay in providing much needed accountability in our health system. Medicare is the single largest social transfer in Canada. Through our pooled resources - tax revenues that are collected by both the federal and provincial governments - it provides access to life saving and life enhancing services for tens of millions of us. The duty of all levels of government to the residents of this country is to provide the most transparent and democratic governance of this system possible.
Our organization has monitored the use of funding in the health care system as closely as possible. What we have found is disturbing. In major sectors of the health system Ontarians are paying more and receiving less. In key instances the interests of private for-profit corporations have trumped the interests of fiscal responsibility and public governance. Services critical to the livelihoods of millions have been cut. Most recently, our provincial government has started to create "public private partnership" hospitals - for-profit hospitals that could hide billions of dollars in public debt from public scrutiny if they are allowed to proceed.
This week, the premiers will meet in Charlottetown to discuss Romanow's recommended Health Council, among other issues. We want to remind you at this time that the most important voices - the voices of the people of Ontario and Canada - have already spoken through the Romanow Commission and through countless polls and opinion surveys. The message is clear: Ontarians and Canadians want more accountability in our health system.
It is time for your government to act decisively in the interests of the people of this country for the health and sustainability of Medicare. It is imperative that our democracy and our health not be traded away for short-term interests, nor held hostage in negotiations on other federal-provincial issues. As the premiers come out of their meetings this week we will be looking for you to send a strong message to Canadians by committing at minimum to do the following:
-ensure that the federal Ministry of Health enforces the Canada Health Act as specified by the Auditor General in her report last fall;
-ensure that Federal health transfers are accompanied by honest and strongly independent reporting to Canadians about health care spending and performance;
-resist allowing the Health Council to be dominated by for-profit health care corporations and the political and ideological interests of premiers who oppose a national public healthcare system;
-improve legitimate democracy in the governance of the health system.
Canadians pay taxes to the federal government as well as to provincial governments. The Canada Health Act is a national statute defining a national program about which there is unparalleled consensus across the country. As such, your government has a clear mandate to ensure that the health system is accountable to Canadians. We strongly urge you to ensure that your duty to the residents of this country supersedes the interests of the for-profit health care industry and the provincial premiers who are ideologically opposed to public healthcare.
The Canada Health Act specifies that Medicare should be governed by a public administration, recognizing that our health system does not belong to politicians and it certainly does not belong to transnational for-profit corporations. Public Medicare belongs to the people of this country who fund it, who work in it, and who require it to save, enhance and sustain their lives. This issue is about our health, but it is also about the health of our democracy. We will work to ensure that the outcome of your negotiations with the premiers is measured against the commitments we are asking of you.
(Original Signed)
Ethel Meade
Co Chair - Ontario Health Coalition
cc. Ontario Premier Ernie Eves
Homecare Privatization - The End of 100 Years of Nonprofit Home Nursing?
Background
In 1996, the provincial conservative government established 43 Community Care Access Centres to govern delivery of homecare in Ontario. The CCACs were directed to contract for services through a competitive bidding process. In this process, private for-profit corporations were invited to compete for contracts against the non-profit service providers. For-profit companies, offering lower wages and poorer working conditions under-bid the non-profits and won contracts across Ontario. Ontario's long-standing non-profit home nursing and support services have been devastated. Unstable employment, poor wages and difficult working conditions have contributed to nursing and home support staff shortages.
Case Study: Victorian Order of Nurses
The VON has provided home nursing and support since 1897 across Ontario. Since the Conservative government's move to privatize homecare, the VON has lost significant portions of home nursing services all across Ontario. The latest cuts include:
*VON lost the nursing contract in Sudbury. For-profit Bayshore Health Inc. won.
*VON lost the nursing contract in Haldimand-Norfolk. For-profits Care Plus and Care Partners won.
*VON lost the nursing contract in Kenora-Rainy River. For-profit Comcare won.
*VON lost 55% of the nursing contract in North Bay. For-profit Paramed won.
*VON withdrew nursing services in Victoria-Haliburton because they were losing too much money to continue. For-profit Paramed has taken over the contract.
*VON withdrew nursing services in Kingston, Frontenac, Lennox & Addington because they are unable to afford to continue.
What's the Difference?
85-90% of the costs for providing homecare are nurse and homemaker salaries and benefits. The difference between the non-profits and the for-profits is in wages and working conditions for these front-line healthcare workers.
¤ VON pays nurses by the hour.For-profits pay per visit.
¤ VON covers mileage, pays workers to do their paperwork and other required reporting. For-profits pay a rate per visit that may or may not fairly reimburse for this time.
¤ VON provides benefits for their staff. For-profits often do not.
¤ VON operates on a non-profit basis with a mandate to provide community service as set by its mission statement and controlled by an elected Board of Directors. For-profits are investor-controlled and operate to provide a profit or rate of return on investment.
Staff Shortages Voting With Their Feet
When competitive bidding and the forced privatization of homecare was started, the price per visit declined by an average of 12% across Ontario. Staff were laid off and forced to re-apply for their jobs at lower wages and poorer working conditions. Predictably, severe staffing shortages were the consequence. As VON nurses lose their jobs in rural communities, they are faced with the choice of applying to work for a for-profit company that underbid their non-profit. In this company they are likely to be paid less or lose their coverage for mileage and/or their benefits. Or they can seek work in a long term care facility or hospital where the pay is better. Home support nurses and workers are voting with their feet, leaving the stressful, unstable and unsupported homecare sector and moving to hospitals, nursing homes and other provinces or countries.
Cuts
Due to sudden and unexpected provincial government cuts in the spring of 2002, tens of thousands of frail elderly and disabled patients lost their home support services. In total, the effect of this was:
¤ reduction of 115,000 patients served from April 1/01 - April 1/03
¤ 6 million hours of service were cut - a 30% drop
source: Ontario Home Health Care Providers Association & Ontario Community Support Association, Dec 02
Medicare is fundamentally about equality. Most caregivers, users and workers in the healthcare system are women, who are deeply affected by the radical changes that have taken place over the last decade. But women's voices and women's needs are not being heard by policy makers whose decisions are so profoundly affecting women's lives.
Because of this, the Ontario Health Coalition created a project to gather first-hand information from women about what changes to the health system have meant. The goal of the project is to collect and release this data, to create resources and engage women's organizations in the debate about the future of Medicare, and to increase the involvement of women in policy making regarding our health.
Dozens of women's organizations and individual women participated in focus groups and generously shared their personal experiences with the health system. Their stories and insights have been collected and have provided the basis for the production of a series of materials to be used for public awareness. A kit of tools and resources has been created and is available on the health coalition website, click here to go to our Listen Up! Resource Page or order the materials by contacting the Ontario Health Coalition office at 416-441-2502.
Available resources include:
¤ Women & Long Term Care (fact sheet)
¤ Women as Healthcare Workers (fact sheet)
¤ Women & Homecare (fact sheet)
¤
How Women Can Get Involved (fact sheet)¤
Health Restructuring and Women's Access (fact sheet)¤ Report from focus groups
¤ Women & Healthcare Privatization (fact sheet)
¤ Listen Up! Poster
¤ Women & Healthcare Lobby Kit
Note: fact sheets are available in several languages
Women have engaged by participating in letter-writing circles, lobbying MPs and MPPs, getting involved in local health coalitions and in public actions, and by spreading the word and sharing the information. And more is on its way! Look for the upcoming report on Women and the Future of Medicare to be released in the fall. Click here to view the above resources and more on our Listen Up! Resource Page
Resources & Reports
The following are available by contacting the Ontario Health Coalition at 416-441-2502 or ohc@sympatico.ca or click the links below to view or download.
*
Waiting In the Wings - A report by the Polaris Institute on the for-profit corporations vying to take over our health system. Available at www.polarisinstitute.org*
P3s: Importing a British Failure - A new OHC fact sheet on Britain's experience with public private partnership (P3) hospitals.Click here to download.*
The Cure is Worse Than What Ails Us - Ontario Alternative Budget report on healthcare spending put out by the Canadian Centre for Policy Alternatives. It is available at www.policyalternatives.ca. The OHC has also put out a series of media fact sheets and briefs on health spending and the provincial budget available on our website.*
First Hospitals then Schools - A new article on P3s from the OHC.*
Private Finance Initiative - A new video from Britain on P3 hospitals. Produced by CUPE. Call 416-599-0770 for a copy.*
Fact Sheet on Homecare Privatization - A new fact sheet on homecare cuts and privatization from the OHC.Click here to download.*
Women & Medicare - A new series of fact sheets available in several languages from the OHC.Click here to view the English resources.More new reports and fact sheets are available on a variety of topics. Call us for more information or check out our website.
Ontario Health Coalition
15 Gervais Drive, Suite 305
Toronto,
Ontario M3C 1Y8
tel: 416-441-2502
fax: 416-441-4073
email:
ohc@sympatico.ca