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The Sudbury Star Wed Sep 16 2015

A former health minister from the United Kingdom says he believes "private clinics are a bad option for the people of Canada." Frank Dobson, who was health minister from 1997 to 2000 in Tony Blair's Labour Party government, made a stop in Sudbury on Tuesday. Dobson was invited by the Ontario Council of Hospital Unions (OCHU) to speak about the pitfalls of privatization of health-care services in the United Kingdom. He is visiting eight other communities in the province to give his take on health-care privatization and how it may affect the health-care system in Ontario. "I wouldn't recommend the British model to anyone because it has basically been a rip off," Dobson said.

"The money going into running the system (in Britain) has gone up from between four and six per cent of the total National Health Service spending to somewhere between 12 and 15 per cent of NHS spending going on this semi-commercial system and that is somewhere around 8 billion pounds a year extra going on the cost of running the services (that are) not going on patient care, Dobson said. Dobson also provided other examples of why the system is flawed in the Britain.

The Globe and Mail Mon Mar 23 2015

Konrad Yakabuski argues medication should be publicly provided, as it largely is in Britain, which seems reasonable (An Affordable Step Toward True Universality - March 19). But when he argues that permitting private health insurance and health care would relieve the strain on public health care, again pointing to Britain, I disagree with his assessment of what's happening here. The private health sector in Britain consists primarily of 200 mini-hospitals, most with fewer than 50 beds, at which some surgeons and anesthetists in National Health Service hospitals earn extra money doing routine surgery on low-risk, fee-paying patients in their spare time.

Recent work by the Centre for Health and the Public Interest found these hospitals are less safe than full-service NHS hospitals; some 6,000 patients a year are transferred from private hospitals to NHS hospitals, half in emergencies. The private sector here does not "free up public monies," it is subsidized by public money. Colin Leys, Centre for Health and the Public Interest, London

The provincial government's decision to pursue public-private partnerships (P3s) in the construction of the North Battle ford hospital and the new Plains outpatient surgery centre in Regina puts taxpayers at risk.

The experience of P3s in Canada and Britain shows that these end up costing more than traditional government financing.

In 2008, Ontario's auditor general revealed that the Brampton's P3 hospital could have been built for $194 million less if it had been done through

Windsor Star Mon May 4 2015

A long-running dispute between Dr. Brian Day, the co-owner of Cambie Surgeries Corp., and the British Columbia government may finally be resolved in the BC Supreme Court this year - and the ruling could transform the Canadian health system from coast to coast. The case emerged in response to an audit of Cambie Surgeries, a private for-profit corporation, by the BC Medical Services Commission. The audit found from a sample of Cambie's billing that it (and another private clinic) had charged patients hundreds of thousands of dollars more for health services covered by medicare than is permitted by law. Day and Cambie Surgeries claim the law preventing a doctor charging patients more is unconstitutional.

Day's challenge builds on the legacy of a 2005 decision by the Supreme Court of Canada overturning a Quebec ban on private health insurance for medically necessary care. But this case goes much further, not only challenging the ban on private health insurance to cover medically necessary care, but also the limits on extra-billing and the prohibition against doctors working for both the public and private health systems at the same time. A trial date was set to begin in 2012, but was adjourned until March 2015 so that the parties could resolve their dispute out of court and reach a settlement. It now appears such a resolution has not been reached and the court proceedings may resume in November. Here's why this case matters.

The Globe and Mail Sat May 23 2015

It's 4:30 on a Friday afternoon at her Sherbrooke, Que., clinic and Marie Hayes takes a deep breath before opening the door to her final patient of the day, who has arrived without an appointment. The 32-year-old mother immediately lists her complaints: She feels dizzy. She has abdominal pain. "It is always physical and always catastrophic," Dr. Hayes will later tell me. In the exam room, she runs through the standard checkup, pressing on the patient's abdomen, recording her symptoms, just as she has done almost every week for months. "There's something wrong with me," the patient says, with a look of panic. Dr. Hayes tries to reassure her, to no avail. In any case, the doctor has already reached her diagnosis: severe anxiety. Dr. Hayes prescribed medication during a previous visit, but the woman stopped taking it after two days because it made her nauseated and dizzy. She needs structured psychotherapy - a licensed therapist trained to bring her anxiety under control. But the wait list for public care is about a year, says Dr. Hayes, and the patient can't afford the cost of private sessions.

Meanwhile, the woman is paying a steep personal price: At home, she says, she spends most days in bed. She is managing to care for her two young children - for now - but her husband also suffers from anxiety, and the situation is far from ideal. Dr. Hayes does her best, spending a full hour trying to calm her down, and the woman is less agitated when she leaves. But the doctor knows she will be back next week. And that their meeting will go much the same as it did today. In its broad strokes, this is a scene that repeats itself in thousands of doctors' offices every day, right across the country. It is part and parcel of a system that denies patients the best scientific-based care, and comes with a massive price tag, to the economy, families and the health care system. Canadian physicians bill provincial governments $1-billion a year for "counselling and psychotherapy" - one third of which goes to family doctors - a service many of them acknowledge they are not best suited to provide, and that doesn't come close to covering patient need. Meanwhile, psychologists and social workers are largely left out of the publicly funded health-care system, their expertise available only to Canadians with the resources to pay for them.

Its program helps families shoulder the burden

By Chris Farrell

And those who’ll need long-term care can expect to incur costs of $138,000, on average, estimate Melissa Favreault of the Urban Institute and Judith Dey of the U.S. Department of Health and Human Services.

The NHS Trust that runs the hospital says the PFI deal has caused problems

03 June 2015

Britain’s first NHS hospital financed and built by private capital is a “major” fire safety risk, fire fighters have said. The Cumberland Infirmary in Carlisle was first opened in 2000 under the controversial “private finance initiative” which sees the NHS pay a private company rent-like payments to make use of facilities.An independent report commissioned by the NHS trust that manages the hospital found that fire proofing materials installed by the private company did not meet the required protection standard to allow for save evacuation and prevent a fire from spreading across the building.

Toronto Star Fri Jan 15 2016

Carol Goar

The harder the Ontario government beats the drum for home care, the more worried York University sociologist Pat Armstrong becomes. "We're kidding ourselves if we think we can care for everybody at home. There will always be people who need 24-hour nursing care. We can't neglect them."

By Lauren Vogel | CMAJ | Aug. 23, 2016

A federal cash injection won’t fix Canada’s health system, said Health Minister Dr. Jane Philpott in an address to the Canadian Medical Association (CMA) General Council on Aug. 23. “This year the Canada Health Transfer reached a historic high of over $36 billion, but I am firmly convinced that we have an obligation as a federal government to do more than simply open up the federal wallet,” Philpott said. Upcoming negotiations of a new health care accord between the federal government, provinces, and territories present a “rare opportunity” to reshape the system to meet the demands of an aging population, she added. However, Philpott stopped short of making any new funding promises beyond existing commitments in home care, health care information and indigenous health. “It’s not something that I will decide myself,” she said, in reference to provincial and territorial health ministers. “I’m one of 14 people having these conversations.”

A new hospital built under a private finance initiative (PFI) is set to lose so much money it threatens the future of a health trust, it has been claimed.

Health watchdog Monitor has concluded Peterborough and Stamford Hospitals NHS Trust is "not financially sustainable".

Inspectors said the trust worked well "clinically" but would lose £38m a year under present arrangements.

Over the past 15 years a coalition of liberals and conservatives has brought in for-profit free schools in education, has sliced welfare to pay off the deficit and has privatised large parts of the health service.

Sweden's private equity industry has grown into the largest in Europe relative to the size of its economy, with deals worth almost £3bn agreed last year. The key to this takeover was allowing private firms to enter the healthcare market

There are now six private hospitals funded by the taxpayer in Sweden, about 8% of the total.

Toronto Star Sat Aug 27 2016

Preparations are underway for a milestone summit this fall that could be a defining moment for Canadian quality of life in the 21st century. Ottawa appears determined to overhaul Canada's $219-billion health-care industry. It is keen to use the once-in-a-decade expiry of the Health Accord as the opportunity for reform. The Health Accord is the means by which Ottawa injects funds into Medicare with health-care transfers to the provinces and territories, and renegotiation of a new accord has consumed several months.

At this historic moment, the feds are prepared to be the prime architect of change, if balky provinces and territories put up their usual stubborn resistance to it. Provinces and territories have consistently demanded more money from Ottawa with no strings attached. They denounce specific uses of the funds as a federal intrusion on their bailiwicks. But as Jane Philpott, the federal health minister, said earlier this week, "There has never been a major development in the history of health care in Canada where the federal government was not there." Indeed.

The Telegram (St. John's) Tue May 24 2016

Socialist Action is gaining a foothold in Newfoundland Labrador and it is needed now more than ever. The provincial government has tabled an austerity budget that will have drastically regressive effects on public services, seniors, women, youth, those most vulnerable, and the provincial economy as a whole. The provincial government's budget is a stark contrast to Alberta's budget, where low commodity prices have also taken a big bite and the NDP government has taken a different course than that of the Liberal government in N.L. There is nothing in our b

udget about creating jobs, eradicating poverty, improving literacy, providing opportunities for young Newfoundlanders and Labradorians, enhancing life in rural communities and for seniors, eliminating the gender wage gap, and improving mental health programs.

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Mr Peterson* has had advanced Parkinson’s Disease for several years and his wife has finally been pushed to her limits caring for him at home. Mrs Dhaliwal* has suffered from Alzheimer’s Dementia for years, and she is now struggling with major behavioural challenges, worsened by a urinary infection that has further clouded her thinking and ability to communicate. The consultant shakes her head and says, “That’s two beds that we won’t be able to clear for at least a few weeks”. A non-medical onlooker would probably find our exchange disturbing — we seem more focused on the beds these patients are occupying rather than on how we might help them. But to me, the situation is so familiar that for a brief moment I forget that I’m not in my usual digs in Canada but in the United Kingdom. Indeed, this defeatist attitude can be seen over and over across the spectrum of health care settings, all over the developed world, as we struggle with the wrongly-labelled “Silver Tsunami” of aging populations — even though we have known for decades that a baby boom would eventually lead us to where we are today.

Now, thanks to advances in medicine, we are living much longer lives, likely with a number of illnesses that have become rendered as chronic diseases. However, while our patients have changed, our health care systems haven’t — the focus needs to shift from just fixing issues to keeping these patients living independently in the community with increasing levels of homecare or nursing care.    Instead, our hospitals, designed to deal with discrete emergent issues, have become incubators for these patients as they await the right “social” environment for their discharge. Such patients take up about 15% of Canada’s acute care beds — representing 7,500 Canadians each day and at an annual cost of $2.3 billion annually, with dementia alone accounting for over 30% of such hospitalization days. This keeps us in a near-constant state of overcapacity. The situation is similar in other developed countries like the United Kingdom. It is high time to refocus and redevelop our health care systems to respond to the unique needs of our aging population, who collectively represent 60% of all hospital days in Canada.

Total drug costs rose just 4 per cent between 2010 and 2011, the Canadian Institute for Health Information reports.Michael Hunt, director of pharmaceuticals at CIHI, said this is a “far cry” from the double-digit increases that were commonplace through the 1990s and 2000s. In fact, it’s the smallest annual increase since 1985, when national record-keeping began.

“Spending is slowing down,” Mr. Hunt said. He cited a number of inter-related factors:* Patent expiration for some blockbuster drugs, such as Lipitor, have resulted in cheaper generic versions being available.* Tough new generic pricing policies; Ontario for example sets the price of generics at 25 per cent of the brand name price, down from 50 per cent.* Policies like generic substitution, where insurance plans cover only the price of the generic, not the brand name drug.* Changing usage patterns – for example, re-thinking how cholesterol-lowering drugs like statins are prescribed.* The number of new drugs brought to market has been falling steadily for the past decade.

While spending may be waning, Canadians remain among the most enthusiastic consumers of drugs in the world.

small Dutch town of Weesp

Hogewey, where Jo Verhoeff lives, has developed an innovative, humane and apparently affordable way of caring for people with dementia.

a traditional nursing home for people with dementia – you know: six storeys, anonymous wards, locked doors, crowded dayrooms, non-stop TV, central kitchen, nurses in white coats, heavy medication

The growing crisis of public private partnership (P3) hospitals in Britain has now forced the health minister to announce that he will be sending in “hit squads” to make savings at twelve hospitals where the P3 contracts have gone “horribly wrong”

This is a follow up from the government's February announcement that the twelve P3 (or, as the British call them, "PFI") hospitals would get £1.5 billion in emergency funding to help them avoid cutting patient services as a result of their P3 deals.

we will be prepared to financially help them, solely with the burden of the PFI repayments, because it is a millstone round their neck."

registered dietitian Paule Bernier of Montreal's Jewish General Hospital, who co-authored a study on how poorly designed Canadian hospital food is

Farm to Cafeteria Canada, which is trying to get more local food into hospitals

Plow to Plate and Healthy Food in Health Care, two U.S. initiatives