Democracy Gone Astray

Democracy, being a human construct, needs to be thought of as directionality rather than an object. As such, to understand it requires not so much a description of existing structures and/or other related phenomena but a declaration of intentionality.
This blog aims at creating labeled lists of published infringements of such intentionality, of points in time where democracy strays from its intended directionality. In addition to outright infringements, this blog also collects important contemporary information and/or discussions that impact our socio-political landscape.

All the posts here were published in the electronic media – main-stream as well as fringe, and maintain links to the original texts.

[NOTE: Due to changes I haven't caught on time in the blogging software, all of the 'Original Article' links were nullified between September 11, 2012 and December 11, 2012. My apologies.]

Thursday, May 02, 2013

Ontario budget will see more hospital downsizing and community upsizing, health minister says

Ontario hospitals are shrinking at a rapid rate and while some say cuts to beds, staff and services are hurting patients, the province’s health minister argues they are “deliberate” and necessary.

Health Minister Deb Matthews said Thursday’s budget will see the province stay the course on downsizing hospitals, but at the same time funding for home and community health services will increase to pick up the slack.

Base funding for the province’s 149 hospital corporations is expected to remain frozen, meaning they will not get significantly more than the $17 billion they got last year. Meantime, funding for community and home care will jump by $260 million to $4.56 billion.

Health-care inflation and demographic changes are forcing hospitals to cut their own budgets to avoid deficits.

Patient advocates and many who work in hospitals argue that patient care is suffering and contend there are not enough community services to meet growing needs.

“These are going to be very, very hard cuts to the hospital but we have to do them to balance our books,” said Dr. Robert Ting, president of the Scarborough Hospital’s medical staff association.

On Wednesday afternoon, staff at the hospital attended town hall meetings where they were told more cuts were coming. The hospital is looking at closing two operating rooms, a surgical wing with up to 20 beds and several outpatient clinics, including a rheumatology clinic for patients with arthritis. Earlier in the year, they were told 98 staff positions were being eliminated.

Similar town hall meetings were held last week at Trillium where 30 beds are being closed and 100 employees have been given layoff notices.

Other hospitals across Ontario are facing varying degrees of similar cuts. They include: Toronto East General Hospital, the Ottawa Hospital, St. Joseph’s Healthcare London, Perth and Smith Falls District Hospital, Quinte Health Care, Chatham-Kent Health Alliance, Muskoka Algonquin Healthcare and the Windsor Regional Hospital.

Meantime, there is talk of more controversial hospital mergers in Scarborough and Northern Ontario.

Natalie Mehra of the Ontario Health Coalition charged that seniors and residents of rural communities are bearing the brunt of the cuts.

“The government’s attempt to downplay their health-care cuts is demonstrably false. Hospital beds are being closed in significant numbers and these services are not being replaced in local communities,” Mehra said.

Hospital officials say the cuts are not disruptive because new models of providing care mean fewer beds are needed and some have even been sitting vacant. And they say many employees who have received layoff notices are being offered early retirement packages or are being redeployed to fill vacancies.

But some insiders say the cuts are having a big impact.

“People will notice for elective things. Things that are super urgent will still get done, but non-urgent things like hernia repairs or gallbladder (surgeries) will definitely get pushed back,” Ting said.

Ontario hospitals are struggling to balance their budgets in the face of a new funding formula that sees them getting lower annual increases from the province.

Matthews said the shift from hospital to community care, though bumpy, demonstrates the success of the transformation of Ontario’s health system.

“This is a deliberate strategy,” she said.

Matthews said the provincial budget will hold the line on hospital spending and boost spending in community care and home care by 6 per cent.

“We are making big investments in the community so people can get out of hospital and home more quickly,” she said. “It’s better quality of care at home and it’s where people want to be.”

But Jane Meadus, a lawyer with the Advocacy Centre for the Elderly, has a different perspective. She said she gets calls daily from seniors in tears over being forced out of hospital.

They can’t get into long-term care because there are no beds or the few beds that exist are in homes with poor compliance records or are so far from family that they would rarely get visits, Meadus said.

Though layoffs are being minimized through buyouts and attrition, staffing complements in hospitals are shrinking.

Matthews acknowledged hospital employees are upset by the changes, but said that as their sector shrinks, more job opportunities are being created in the community.

According to the Ontario Hospital Association, there are 30,881 hospital beds in Ontario today, 38 per cent fewer than in 1990. But that’s not such a bad thing, said OHA president Pat Campbell.

“This is because surgeries have become less invasive, more care is being done on an outpatient basis, and investments in community care have helped lead to shorter lengths of stays in hospitals for patients,” she said. “Ultimately, Ontario is providing patient care more efficiently, and the trends in hours worked in nursing in-patient units, on the whole, correspond with those gains.”

Original Article
Source: thestar.com
Author: Theresa Boyle

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