Skip to main content

Home/ CUPE Health Care/ Group items tagged complaints

Rss Feed Group items tagged

Filter: All | Bookmarks | Topics Simple Middle
Irene Jansen

Ontario nursing home task force flooded with ideas for change - thestar.com - 1 views

www.thestar.com/...-flooded-with-ideas-for-change

ltc ontario abuse union seniors complaints federal

shared by Irene Jansen on 16 Mar 12 - No Cached
  • A long-term care task force created after a Star investigation into nursing home abuse has been swamped with complaints — and ideas for change.
  • The Long-Term Care Task Force on Resident Care and Safety
  • is expected to give Health Minister Deb Matthews its report recommending tangible change by the end of April.
  • ...7 more annotations...
  • focus on the culture of secrecy found in homes that refuse to acknowledge problems exist
  • Submissions are accepted through its website at www.longtermcaretaskforce.ca until March 19.
  • Canada-wide problems with the financial and physical abuse of the elderly was the focus of a federal government announcement Thursday morning when Justice Minister Rob Nicholson proposed changes to the Criminal Code that would require judges to consider the age of the victim during sentencing.
  • But Judith Wahl, a lawyer with the Advocacy Centre for the Elderly said judges can already to take into account the age of the victim during sentencing.
  • The proposed legislation, she said, does little to actually prevent the harm facing seniors — sometimes from their own families. In many cases, the elderly would benefit more from affordable housing or home care to save them relatives who “influence” them to hand over money.
  • Prevention is key, agreed Doris Grinspun, chief executive officer of the Registered Nurses Association of Ontario
  • “Our elders need security and dignity,” said Sharleen Stewart of the Service Employees International Union. “With a growing political focus on seniors, the time has probably come for a national seniors’ strategy.”
Irene Jansen

HCA, Giant Hospital Chain, Creates a Windfall for Private Equity - NYTimes.com - 0 views

www.nytimes.com/...ndfall-for-private-equity.html

us hospital hca fraud staffing quality corporation

shared by Irene Jansen on 22 Aug 12 - No Cached
  • profits at the health care industry giant HCA, which controls 163 hospitals from New Hampshire to California, have soared
  • The big winners have been three private equity firms — including Bain Capital, co-founded by Mitt Romney, the Republican presidential candidate — that bought HCA in late 2006.
  • only a decade ago the company was badly shaken by a wide-ranging Medicare fraud investigation that it eventually settled for more than $1.7 billion
  • ...24 more annotations...
  • 35 buyouts of hospitals or chains of facilities in the last two and a half years by private equity firms
  • Among the secrets to HCA’s success: It figured out how to get more revenue from private insurance companies, patients and Medicare by billing much more aggressively for its services than ever before; it found ways to reduce emergency room overcrowding and expenses; and it experimented with new ways to reduce the cost of its medical staff
  • HCA decided not to treat patients who came in with nonurgent conditions, like a cold or the flu or even a sprained wrist, unless those patients paid in advance.
  • In one measure of adequate staffing — the prevalence of bedsores in patients bedridden for long periods of time — HCA clearly struggled. Some of its hospitals fended off lawsuits over the problem in recent years, and were admonished by regulators over staffing issues more than once.
  • inadequate staffing in important areas like critical care
  • Many doctors interviewed at various HCA facilities said they had felt increased pressure to focus on profits under the private equity ownership. “Their profits are going through the roof, but, unfortunately, it’s occurring at the expense of patients,” said Dr. Abraham Awwad, a kidney specialist in St. Petersburg, Fla., whose complaints over the safety of the dialysis programs at two HCA-owned hospitals prompted state investigations.
  • One facility was fined $8,000 in 2008 and $14,000 last year for delaying the start of dialysis in patients, not administering physician-prescribed drugs and not documenting whether ordered tests had been performed.
  • Claiming he provided poor care, the other hospital did not renew Dr. Awwad’s privileges. Dr. Awwad is suing to have them reinstated.
  • “If you were a for-profit hospital with investors and shareholders,” said Paul Levy, a former nonprofit hospital executive in Boston unaffiliated with HCA, “there would be a natural tendency to be more aggressive and to seek more revenues.” Executives at profit-making hospitals are “judged in greater measure by profitability” than the administrators of nonprofit hospitals, he said.
  • some of HCA’s tactics are now under scrutiny by the Justice Department. Last week, HCA disclosed that the United States attorney’s office in Miami has requested information about cardiac procedures at 10 of its hospitals in Florida and elsewhere.
  • HCA’s cardiac business is extremely lucrative, and the Justice Department has requested reviews that HCA conducted that indicate some of the heart procedures at some of its hospitals might not have been necessary and resulted in unjustified reimbursements from Medicare and other insurers.
  • Small and nonprofit hospitals are closing or being gobbled up by medical conglomerates, many of which operate for a profit and therefore try to increase revenue and reduce costs even as they improve patient care. The trend toward consolidation is likely to accelerate under the Obama administration’s health care law as hospitals grapple with what are expected to be lower reimbursements from the federal and state governments and private insurers.
  • Columbia/HCA became the target of a widespread fraud investigation in the late 1990s, which led to one of the largest Medicare settlements ever.
  • HCA wanted to attract more patients to its emergency rooms, and it did. Annual visits climbed 20 percent from 2007 to 2011. But while emergency departments are often a critical source of patient admissions, they are frequently money-losers because many patients do not have insurance. HCA found a solution: it figured out how to be paid more for the patients it was seeing.
  • Nearly overnight, HCA’s patients appeared to be much, much sicker.
  • No one has accused HCA of up-coding, or billing for more expensive services that were not needed — one of the complaints made against it a decade ago.
  • The acting head of Medicare is Marilyn B. Tavenner, a former HCA executive who left there in 2005 to become the secretary of Health and Human Resources in Virginia.
  • Several former emergency department doctors at Lawnwood Regional Medical Center in Fort Pierce, Fla., said they frequently had felt compelled to override the screening system in order to treat patients.
  • When the doctors failed to meet the hospital’s goals for how many patients should be considered emergencies, “they really started putting pressure on.”
  • Regulators in several states have taken HCA hospitals to task over screening out patients too aggressively, including situations where the screening missed serious conditions.
  • “Staffing is critical,” said Courtney H. Lyder, the dean at the UCLA School of Nursing and an expert on wound care. “When you see high levels of wounds, you usually see a high level of dysfunctional staff,” he said.
  • HCA owned eight of the 15 worst hospitals for bedsores among 545 profit-making hospitals nationwide, each with more than 1,000 patient discharges, tracked by the Sunlight Foundation using Medicare data from October 2008 to June 2010.
  • an examination of lawsuits shows bedsore problems have been persistent at several HCA facilities
  • The hospital was cited twice by Florida regulators, in 2008 and 2010, for having inadequate numbers of nurses on its staff to oversee wound care for patients.
Irene Jansen

Toronto News: Sick seniors need better care - thestar.com - 0 views

www.thestar.com/...1069581

retirement homes regulation coroner ltc ontario

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Frail and sick seniors who need the medical supports found in long-term care are stuck in retirement homes, says an Ontario coroner’s investigation. Dr. Dan Cass told the Star his probe of four deaths at Toronto’s In Touch Retirement Living uncovered problems that affect seniors across Ontario.
  • there was no process to identify their needs, provide options for help or a place where families could complain.
  • Cass began his investigation after the Star published a series on retirement home neglect last fall. Roughly 40,000 Ontario seniors live in some 700 retirement homes, which are privately operated
  • ...4 more annotations...
  • the Ontario government’s new Retirement Homes Act has created a regulatory authority to impose rules that will fix the problems
  • But seniors’ advocates warn that the complaints system is currently toothless because the government still hasn’t passed the regulations that allow it to remove licenses from problem homes.
  • The authority has investigated about 30 complaints about neglect but cannot take away licenses until that part of the act is in force
  • Judith Wahl, executive director of the Advocacy Centre for the Elderly, said the coroner’s investigation shows the office will shine a light on retirement home deaths in the future. But, Wahl said, relying on new legislation will not help the most vulnerable. Retirement homes, she said, are private rental accommodations that will charge medically fragile residents for each medical service they need. The authority, she said, still does not have the powers needed to fully investigate homes.
Irene Jansen

Nursing home neglect - thestar.com - 0 views

www.thestar.com/...1088858--nursing-home-neglect

ltc ontario

shared by Irene Jansen on 23 Jan 12 - No Cached
  • A private nursing home chain enforced such strict rations on diapers that staff wrapped residents in towels and plastic garbage bags to keep their beds dry.
  • A resident at a Bradford home who was prone to falls was left alone on a toilet. The resident fell and sustained a head injury.
  • Residents in a Hamilton home had untreated bedsores and were famished from lack of food.
  • ...15 more annotations...
  • An elderly woman with a broken thighbone in a Pickering nursing home suffered for days without treatment.
  • A Brantford home was so short staffed that residents frequently missed their weekly baths.
  • Eight years after an Ontario government promise to revolutionize nursing home care, the elderly are still suffering neglect and abuse.
  • The Star’s investigation draws from material uncovered by a new inspection system created by the Ministry of Health and Long-Term Care in July 2010. It has since investigated 2,993 complaints and critical incidents, like broken bones or assaults. We analyzed more than 1,500 of those inspection reports and found at least 350 cases of neglect where residents were left in soaking diapers, suffered untreated injuries, bedsores, dehydration, weight loss or were put at risk from outdated care plans that ignored changing medical needs. Other reports, scrutinized for Thursday’s story, focused on abuse. Today the Star probes the issue of neglectful treatment of home residents. The reports reveal that many families have no idea what their loved ones are subjected to. Inspectors found that some homes do not disclose problems to the ministry or police.
  • Diaper shortages can be found in many of Ontario’s 627 homes, said Sharleen Stewart president of the union representing front-line nursing home staff. “Our members tell us the shortages leave residents with rashes and sores,” said Stewart, of the Service Employees International Union, which represents 50,000 Ontario health care workers, including 22,000 nursing home employees.
  • Last November a ministry inspector wrote, “Five different nursing staff members working the day shift from all home areas… indicated they are only provided with one (diaper) per (eight hour) shift for the resident and frequently have to go to another home area to try and borrow products.”
  • The report also described a resident with an open sore whose diaper was soaked in the morning. Since staff could not find a replacement, the resident was only given a paper insert to keep urine from the senior’s wound.
  • Two months later, in January 2011, the ministry was back at the same home, this time investigating a complaint from a family who said their loved one was wearing the same diaper from the previous day and it was “heavily soiled.”
  • Ko dismissed allegations that a Revera home in north Etobicoke rations diapers. But one current and one former resident of Westside Long Term Care on Albion Rd. told the Star residents are only given one diaper per eight-hour shift.
  • She praised the staff, saying they scramble to find an extra diaper if one’s needed. “They’re embarrassed that I’m embarrassed.”
  • Two employees at Westside said the home locks up diapers and staff have to sign them out. The workers at Westside spoke on the condition of anonymity, saying they are afraid of being fired. One worker said she is so worried about leaving residents in wet diapers that she places towels and plastic garbage bags under them to prevent urine from soaking their bed sheets.
  • Revera was “shocked” to hear allegations that makeshift diapers were being used and she has both launched an investigation and is conducting educational sessions for staff
  • Westside workers say their bosses warn staff they will be fired if they tell residents’ families the home is rationing diapers. Whistleblower protection in Ontario homes only helps staff who divulge problems to their nursing home supervisors or the health ministry. It does not protect the jobs of workers who warn residents’ families that their relatives are being neglected, complain to their union or speak to the media.
  • The new inspection report system often hides bad care from public scrutiny. The public report is often stripped of details. A private version for the home’s management, on the other hand, gives precise information about each violation. It took Lorraine Henderson 11 months to obtain copies of these private reports through access to information legislation.
  • The Star’s analysis of inspection reports found more than 50 cases in which elderly residents fell and got injured, many times when they were left unassisted by caregivers or dropped from mechanical lifts.
Govind Rao

Mistreated nursing home residents better off in a concentration camp Australia - 0 views

www.abc.net.au/...4821492

from heather ltc privatization Australia

shared by Govind Rao on 09 Aug 13 - No Cached
  • Govind Rao on 09 Aug 13
     
    By Margot O'Neill, staff Updated Tue Jul 16, 2013 9:06am AEST Traumatised relatives have raised shocking claims that their loved ones were left to die unnecessarily or in great pain because of a critical lack of staff and training in nursing homes. The ABC's Lateline program has spoken to many people about their loved ones' experiences in nursing homes across Australia. Their complaints include relatives being left in faeces and urine, rough treatment, poor nutrition, inadequate pain relief, verbal abuse, and untreated broken bones and infections. And one woman has told the ABC that her grandmother, who survived Nazi concentration camps, believes her experiences in aged care are worse than her wartime ordeal.
Govind Rao

Home care was totally inadequate - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|243387|mtgz|20140913|203971945

from heather home care Quebec cuts

shared by Govind Rao on 15 Sep 14 - No Cached
  • Montreal Gazette Sat Sep 13 2014
  • ""My story, like so many other stories in The Gazette recently, is just another example of Quebec's broken health-care system. My 88-year-old mother, who lives in the Eastern Townships, will be moving into a private long-term care home in two weeks. My siblings and I have done everything we could to prevent this from happening. Several years ago, my mother was diagnosed with Alzheimer's disease. In the past three years, the disease had progressed to the point where she could not be alone. We contacted our local CLSC. After an assessment, it determined she would be given seven hours of assistance per week to ensure she was eating. My mother could not cook, did not know what day it was, and had difficulty dressing and with hygiene. Instead, the family hired a local woman to spend eight hours a day with our mother. Last year, the woman spent eight hours a day and the CLSC did its annual assessment and offered only two hours per day. During this period, my mother had a series of falls, and refused to change her clothes or bathe. She turned the heat off one winter weekend and the pipes froze. Still, the CLSC offered nothing more. The family continued to pay for homecare until she was hospitalized after a fall.
  • I have spent the past 10 months caring for my mother in her home. When I left my family in Ontario to come here, I worked on getting her the services she needed and deserved. I was met with an uncaring, unprofessional system. I have dealt with four different social workers. I contacted the local MP asking for help and he never responded. I filed a complaint with the complaints commissioner and it went nowhere. It was only after I threatened to sue them for negligence that they acted. They offered 21 hours per week, the maximum, which is simply nowhere near enough. It's an unfortunate end to what has otherwise been a good life for our mother. She, like so many like her, will end her days in a strange place, when all she wanted was to live in her own home and die there. Nancy Fraser Stanstead
Govind Rao

MUHC faces legal battle over noise complaints at new hospital - Montreal | Globalnews.ca - 0 views

globalnews.ca/...ise-complaints-at-new-hospital

from heather p3 Quebec hospital quality

shared by Govind Rao on 11 May 15 - No Cached
  • May 11, 2015
  • By Amanda Kelly
  • MONTREAL — Lower Westmount residents are concerned about the fact no one seems to be fixing a very loud problem: a loud, continual humming noise heard 24 hours a day, seven days a week.It comes from the ventilation system of the new McGill University Health Centre (MUHC) on the Glen Campus site, and it’s been bothering a number of residents living in the City of Westmount and the Montreal borough of Côte-des-Neiges–Notre-Dame-Grâce.
  • ...1 more annotation...
  • In December, when the issue was raised in the media, Denis Crevier, an SNC-Lavalin engineer, told Global News the the firm was working on eliminating the noise and the problem was expected to be resolved within a week.
Govind Rao

'We have the evidence ... Why aren't we providing evidence-based care?'; Mental illness... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150523|221089241

from heather mental health privatization

shared by Govind Rao on 26 May 15 - No Cached
  • 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.
  • ...42 more annotations...
  • Imagine if a Canadian diagnosed with cancer were told she could receive chemotherapy paid for by the health-care system, but would have to cough up the cash herself if she needed radiation. Or that she could have a few weeks of treatment, and then be sent home even if she needed more. That would never fly. If doctors, say, find a tumour in a patient's colon, the government kicks in and offers the mainstream treatment that is most effective. But for many Canadians diagnosed with a mental illness, the prescription is very different. The treatment they receive, and how much of it they get, will largely be decided not on evidence-based best practices but on their employment benefits and income level: Those who can afford it pay for it privately. Those who cannot are stuck on long wait lists, or have to fall back on prescription medications. Or get no help at all. But according to a large and growing body of research, psychotherapy is not simply a nice-to-have option; it should be a front-line treatment, particularly for the two most costly mental illnesses in Canada: anxiety and depression - which also constitute more than 80 per cent of all psychiatric diagnoses.
  • Why aren't we providing evidence-based care?" .. The case for psychotherapy Research has found that psychotherapy is as effective as medication - and in some cases works better. It also often does a better job of preventing or forestalling relapse, reducing doctor's appointments and emergency-room visits, and making it more cost-effective in the long run.
  • Therapy works, researchers say, because it engages the mind of the patient, requires active participation in treatment, and specifically targets the social and stress-related factors that contribute to poor mental health. There are a variety of therapies, but the evidence is strongest for cognitive behavioural therapy - an approach that focuses on changing negative thinking - in large part because CBT, which is timelimited and very structured, lends itself to clinical trials. (Similar support exists for interpersonal therapy, and it is emerging for mindfulness, with researchers trying to find out what works best for which disorders.) Research into the efficacy of therapy is increasing, but there is less of it overall than for drugs - as therapy doesn't have the advantage of well-heeled Big Pharma benefactors. In 2013, a team of European researchers collated the results of 67 studies comparing drugs to therapy; after adjusting for dropouts, there was no significant difference between the most often-used drugs - selective serotonin reuptake inhibitors (SSRIs) - and psychotherapy.
  • The issue is not one against the other," says Montreal psychiatrist Alain Lesage, director of research at the Douglas Mental Health University Institute. "I am a physician; whatever works, I am good. We know that when patients prefer one to another, they do better if they have choice." Several studies have backed up that notion. Many patients are reluctant to take medication for fear of side effects and the possibility of difficult withdrawal; research shows that more than half of patients receiving medication stop taking it after six months. A small collection of recent studies has found that therapy can cause changes in the brain similar to those brought about by medication. In people with depression, for instance, the amygdala (located deep within the brain, it processes basic memories and controls our instinctive fight-or-flight reaction) works in overdrive, while the prefrontal cortex (which regulates rational thought) is sluggish. Research shows that antidepressants calm the amygdala; therapy does the same, though to a lesser extent.
  • But psychotherapy also appears to tune up the prefrontal cortex more than does medication. This is why, researchers believe, therapy works especially well in preventing relapse - an important benefit, since extending the time between acute episodes of illnesses prevents them from becoming chronic and more debilitating. The theory, then, is that psychotherapy does a better job of helping patients consciously cope with their unconscious responses to stress.
  • According to treatment guidelines by leading international professional and scientific organizations - including Canada's own expert panel, the Canadian Network for Mood and Anxiety Treatments - psychotherapy should be considered as a first option in treatment, alone or in combination with medication. And it is "highly recommended" in maintaining recovery in the long term. Britain's independent, research-guided scientific body, the National Institute for Health and Care Excellence, has concluded that therapy should be tried before drugs in mild to moderate cases of depression and anxiety - a finding that led to the creation of a $760million public system, which now handles therapy referrals for nearly one million people a year.
  • In 2012, Canada's Mental Health Commission estimated that only about one in three adults and one in four children are receiving support and treatment when they need it. Ironically, anti-stigma campaigns designed to help people understand mental illness may only make those statistics worse. In Toronto, for instance, putting up posters in subway stations in 2010 had the unexpected effect of spiking the volume of walk-ins at nearby emergency rooms by as much as 45 per cent in 12 months. Dr. Kurdyak treated many of them at CAMH. The system, he says, "has been conveniently ignoring this unmet need. It functions as if two-thirds of the people suffering won't get help." What would happen if the healthcare system outright "ignored" two-third of tumour diagnoses?
  • Essentially, argues Dr. Lesage, adding therapy into the health-care system is like putting a new, highly effective drug on the table for doctors. "Think about it," he says. "We have a new antidepressant. It works as well as many others, and it may even have some advantages - it works better for remission - with fewer side effects. The patients may prefer it. And [in the long run] it doesn't cost more than what we have. How can it not be covered?" ..
  • A heavy price This isn't just a medical issue; it's an economic one. Mental illness accounts for roughly 50 per cent of family doctors' time, and more hospital-bed days than cancer. Nearly four million Canadians have a mood disorder: more than all cases of diabetes (2.2 million) and heart disease (1.4 million) combined.
  • Mental illness - and depression, in particular - is the leading cause of disability, accounting for 30 per cent of workplace-insurance claims, and 70 per cent of total compensation costs. In 2012, an Ontario study calculated that the burden of mental illness and addiction was 1.5 times that of all cancers, and more than seven times the cost of all infectious diseases. Mental illness is so debilitating because, unlike physical ailments, it often takes root in adolescence and peaks among Canadians in their 20s and 30s, just as they are heading into higher education, or building careers and families. Untreated, symptoms reverberate through all aspects of life, routinely trapping people in poverty and homelessness. More than one-third of Ontario residents receiving social assistance have a mental illness. The cost to society is clearly immense.
  • Yet, when family doctors were asked why they didn't refer more patients to therapy in a 2008 Canadian survey, the main reason they gave was cost. For many Canadians, private therapy is a luxury, especially if families are already wrestling with the economic fallout from mental illness. Costs vary across provinces, but psychologists in private practice may charge more than $200 an hour in major centres. And it's not just the uninsured who are affected.
  • Although about 60 per cent of Canadians have some form of private insurance, the amount available for therapy may cover only a handful of sessions. Those with the best benefits are more likely to be higherincome workers with stable employment. Federal public servants, notably, have one of the best plans in the country - their benefits were doubled in 2014 to $2,000 annually for psychotherapy. Many of those who can pay for therapy are doing so: A 2013 consultant's study commissioned by the Canadian Psychological Association found that $950-million is spent annually on private-practice psychologists by Canadians, insurance companies and workers compensation boards. The CPA estimates t
  • These are the patients that family doctors juggle, the ones who eat up appointment time, and never seem to get better, the ones caught on waiting lists. Sometimes, they have already been bounced in and out of the system, received little help, and have become wary of trying again. A 40-something mother recovering from breast cancer, suffering from chronic depression post-treatment, debilitated by fear her cancer will return. A university student, struggling with anxiety, who hasn't been to class for three weeks and may soon be kicked out of school. A teenager with bulimia removed from an eatingdisorder program because she couldn't follow the rules. They are the ones dangling on waiting lists in the public system for what often amounts to a handful of talk-therapy sessions, who don't have the money to pay for private therapy, or have too little coverage to get the full course of appointments they need.
  • Canada's investment does not match that burden. Only about 7 per cent of health-care spending goes to mental health. Even recent increases pale when compared to other countries: According to a study by the Canadian Mental Health Association, Canada increased per-capita funding by $5.22 in 2011. The British government, meanwhile, kicked in an extra 12 times that amount per citizen, and Australia added nearly 20 times as much as we did. Falling off a cliff, again and again
  • In Winnipeg, Dr. Stanley Szajkowski watched for months as his patient, a woman in her 80s, slowly declined. Her husband had died and she was spiralling into a severe depression. At every appointment, she looked thinner, more dishevelled. She wasn't sleeping, she admitted, often through tears. Sometimes she thought of suicide. She lived alone, with no family nearby, and no resources of her own to pay for therapy. "You do what you can," says Dr. Szajkowksi. "You provide some support and encouragement." He did his best, but he always had other patients waiting.
  • hat 30 per cent of private patients pay out-ofpocket themselves. When the afflicted don't seek help, the cost isn't restricted to their own pocketbook. People with mental-health problems are significantly more likely to abuse drugs and alcohol, and to become physically sick, further increasing health-care costs. A 2014 study by Oxford University researchers found that having a mental illness reduced life expectancy by 10 to 20 years, roughly the same as did smoking and obesity. A 2008 Statistics Canada study linked depression to new-onset heart disease in the general population. A 2014 U.S. study found that women under the age of 55 are twice as likely to suffer or die from a heart attack, or require heart surgery, if they have moderate to severe depression. The result: clogged-up doctors' offices, ERs, and operating rooms. And an inexorable burden for the patients' families forced to fill the gaps in caregiving - or carry on when they lose a loved one.
  • Patients refer to it as falling repeatedly off a cliff. And they can only manage the climb back up so many times. Family doctors interviewed for this story admitted that they are often "handholding" patients with nowhere else to go. "I am making them feel cared for, I am providing a supportive ear that they may not get anywhere else," says Dr. Batya Grundland, a physician who has been in family practice at Toronto's Women's College Hospital for almost a decade. "But do I think I am moving them forward with regard to their illness, and helping them cope better? I am going to say rarely." More senior doctors have told her that once in a while "a light bulb goes off" for the patients, but often only after many years. That's not an efficient use of health dollars, she points out - not when there are trained therapists who could do the job better. However, she says, "in some cases, I may be the only person they have."
  • Family doctors aren't the only ones struggling to find therapy for their patients. "I do a hundred consultations a year," says clinical psychiatrist Joel Paris, a professor at McGill University and research associate at the Montreal Jewish General, "and one of the most common situations is that the patient has tried a few anti-depressants, they have not responded very well, and from their story it is obvious they would benefit from psychotherapy. But where do they go? We have community clinics here in Montreal with six-to-12-month waiting lists even for brief therapy." A fractured, inefficient system
  • "You fall into the role that is handed to you," says Antoine Gagnon, a family doctor in Osgoode, on the outskirts of Ottawa. He tries to set aside 20-minute appointments before lunch or at the end of the day to provide "active listening" to his patients with anxiety and depression. Many of them are farmers or self-employed, without any private coverage for therapy. "Five of those minutes are spent talking about the weather," he says, "and then maybe you get into the meat of the problem, but the reality is we don't have the appropriate amount of time to give to therapy, even to listen, really." Often, he watches his patients' symptoms worsen over several months, until they meet the threshold of a clinical diagnosis. "The whole system could save on productivity and money if people were actually able to get the treatment they needed."
  • But these issues aren't insurmountable, as other countries have demonstrated. Britain, for instance, has trained thousands of university graduates to become therapists in its new public program, following research showing that, as long they have the proper skills, people don't need PhDs to be effective therapists. Australia, which has created a pay-for-service system, also makes wide use of online support to cost-effectively reach remote communities.
  • Except for a small fraction of GPs who specialize in psychotherapy, few family doctors have the training - or the time - to provide structured therapy. Saadia Hameed, a GP in a family-health team in London, Ont., has been researching access to psychotherapy for an advanced degree. Many of the doctors she has interviewed had trouble even producing a clear definition of therapy. One told her, "If a patient cries, than it's psychotherapy." Another described it as "listening to their woes." A 2007 survey of 163 family doctors in Ontario found that almost four out of five had not received training in cognitive behavioural therapy, and knew little about it. "Do family doctors really need to do that much psychotherapy," Dr. Hameed asks, "when there are other people trained - and better trained - to do it?"
  • What further frustrates treatment for physicians and patients is lack of access to specialists within the system. Across the country, family doctors describe the difficulty of reaching a psychiatrist to consult on a diagnosis or followup with their patients. In a telling 2011 study, published in the Canadian Journal of Psychiatry, researchers conducted a real-world experiment to see how easily a GP could locate a psychiatrist willing to see a patient with depression. Researchers called 297 psychiatrists in Vancouver, and reached 230. Of the 70 who said they would consider taking referrals, 64 required extensive written documentation, and could not give a wait-time estimate. Only six were willing to take the patient "immediately," but even then, their wait times ranged from four to 55 days. Psychiatrists are in increasingly short supply in Canada, and there's strong evidence that we're not making the best use of these highly trained specialists. They can - and often do - provide fee-for-service psychotherapy in a private setting, which limits their ability to meet the huge demand to consult with family doctors and treat the most severe cases.
  • A recent Ontario study by a team at CAMH found that while waiting lists exist in both urban and rural centres, the practices of psychiatrists in those locations tend to look very different. Among full-time psychiatrists in Toronto, 10 per cent saw fewer than 40 patients, and 40 per cent saw fewer than 100 - on average, their practices were half the size of psychiatrists in smaller centres. The patients for those urban psychiatrists with the smallest practices were also more likely to fall in the highest income bracket, and less likely to have been previously hospitalized for a mental illness than those in the smaller centres.
  • And those therapy sessions are being billed with no monitoring from a health-care system already scrimping on dollars, yet spending a lot on this care: On average, psychiatrists earn $216,000 a year. There is nothing to stop psychiatrists from seeing the same patients for years, and no system to ensure the patients with the greatest need get priority. In Australia, Britain and the United States, by contrast, billing for psychiatrists has been adjusted to encourage them to reduce psychotherapy sessions and serve more as consultants, particularly for the most severe cases, as other specialists do.
  • As the Canadian system exists now, says Benoit Mulsant, the physician-in-chief at CAMH and also a psychiatrist, the doctors in his specialty "can do whatever they please. If I wanted, I could have a roster of actor patients who tell me entertaining stories, and I would be paid the same as someone who is treating homeless people. ... By treating the rich and famous, there is zero risk of being punched in the face by a patient." Left out in all this, by and large, are other professionals who can provide therapy. It doesn't help that the rules are often murky around who can call themselves psychotherapists. While psychologists and social workers are licensed under their professional associations, in some provinces a person can call himself a marriage counsellor or music therapist with no one demanding they be certified. In 2007, Ontario passed a law to regulate psychotherapists, requiring them to register with a provincial college that would set standards and handle complaints. Currently, however, the law is in limbo, although the government has said it will finally bring it into force by December. The brain keeps many secrets
  • Science, however, has yet to find depression's equivalent of insulin. Despite being scanned, poked and stimulated over and over and over again, the brain keeps its secrets. The "chemical imbalance" theory is now viewed as simplistic at best. It may not do much for patients, either: A 2014 study published in the journal Behaviour Research and Therapy suggested that, rather than reassuring them, focusing on the biological explanation for depression actually made patients feel more pessimistic and lacking in control. SSRIs work by increasing the amount of serotonin, a chemical that helps deliver messages within the brain and is known to influence mood. But researchers aren't sure why the drugs help some patients and fail with others. "Basically, it's like we have a bucket of water and we pour it over the patient's head," says Dr. Georg Northoff, the University of Ottawa's Michael Smith chair of Neurosciences and Mental Health. "But you want a drug that injects the water in a very specific brain regions or brain system, which we don't have."
  • Critics of therapy have argued that it's basically "good listening" - comparable to having a sympathetic friend across the kitchen table - and that in the real world of mercurial patients and practitioners of varying abilities, a pill just works better. That's true in many cases, especially when the symptoms are severe and the patients is suicidal: a fast-acting medication is safer, and may even be necessary before starting talk therapy. The staunchest advocates of therapy do not suggest it should be the first course of treatment for psychosis, or debilitating chronic depression, or mania - although, in those cases, there is evidence that psychotherapy and medication work well in tandem. (A 2011 meta-analysis found that patients with severe depression who received a combination approach had higher recovery rates and were less likely to drop out of treatment.) But drugs also don't work as well as the manufacturers would like us to think. Roughly one-third of patients given a drug will see no benefit (although they often respond to a second or third medication). In randomly controlled trials, drugs often perform only marginally better than sugar pills.
  • Yet it's talk therapy that the public often views most skeptically. "Until you go to a therapist, or a member of your family has a serious psychological problem, people are unsympathetic [about therapy]," says Dr. Paris, the Montreal psychiatrist. "They are very skeptical, and they don't believe the research. It's amazing, because pharmaceutical trials will get approval for a drug on the basis of two clinical trials that they paid for. And we have 100 clinical trials and no one believes us."
  • Dr. Ajantha Jayabarathan, an assistant professor at Dalhousie University's medical school, spent her early years as a family doctor in Spryfield, N.S., trying to manage an overload of mental-health cases. Most of her patients had little insurance; there was one reduced-cost counselling service in town, but the waiting lists were long. In 2000, her group practice became a test site for a shared-care project, which gave the doctors access to a mental-health team, including weekly in-person consultations with a psychiatrist. "It was transformative," she says. "We looked after everything in-house.
  • Over time, Dr. Jayabarathan says, she learned how to properly assess mental illness in patients, and how to use medication more effectively. "I just made it my business to teach myself what to do." It's the kind of workaround GPs are increasingly experimenting with, waiting for the system to catch up. Who would pay - and how?
  • The case for expanding publicly funded access to therapy is gaining traction in Canada. In 2012, the health commissioner of Quebec recommended therapy be covered by the province; it is now being studied by Quebec's science-based health body (INESSS), which is expected to report back next year. A new Quebec-based organization of doctors, researchers and mental-health advocates called the Coalition for Access to Psychotherapy (CAP) is lobbying the government.
  • In Manitoba, the Liberal Party - albeit well behind in the polls - has made the public funding of psychologists one of its campaign platforms for the province's spring 2016 election. In Saskatchewan, the government commissioned, and has since endorsed, a mental-health action plan that includes providing online therapy - though politicians have given themselves 10 years to accomplish it. Michael Kirby, the former head of the Canadian Mental Health Commission, has been advocating for eight annual sessions of therapy to be covered for children and youth in need.
  • There are significant hurdles: Which practitioners would provide therapy, and how would they be paid? What therapies would be covered, and for how long? Complicating every aspect of major mentalhealth change in Canada is the question of who should shoulder the cost: the provinces or Ottawa. In a written statement in response to questions from The Globe and Mail, federal Health Minister Rona Ambrose lobbed the issue back at her provincial counterparts, pointing out that the Canada Health Act does not "preclude provinces and territories from extending public coverage to other services or providers such as psychologists."
  • One result can be overloaded family doctors minimizing mental-health problems. "If you have nothing to offer someone," asks Dr. Anderson, "how much are you going to dig around to find out what is going on?" Some doctors also admit that the lack of resources can lead to physicians cherry-picking patients who don't have mental illness. And yet family physicians alone bill about $361million a year for counselling or psychotherapy in Canada - 5.6 million visits of roughly 30 minutes each. This is a broad category, and not always specifically related to mental health (some of it includes drug counselling, and a certain amount of coaching is a necessary part of the patient-doctor relationship). When it is psychotherapy, however, doctors admit it's often more supportive listening than actual therapy.
  • So how would Canada pay for access to such therapy? It wouldn't be cheap, in the short term. The savings would come from what Canadians would not have to spend in the long term: in additional medical and drug costs, emergency-room visits and hospital stays, and in unnecessary disability payments, to say nothing of better long-term health outcomes for patients given good care earlier. Some of the figures being tossed around sound staggering. Rolling out a version of Britain's centre-based program across Canada would cost $950-million. Michael Kirby's plan would amount to $1,000 annually per patient. A 2013 report commissioned by the Canadian Psychological Association calculated that, based on predicted need, and assuming no coverage from private health-care plans, providing an average of six sessions of therapy a year would cost an estimated $2.8-billion annually.
  • But any of those figures would still be a fraction of the roughly $210-billion that Canada spends annually on health care. Figuring out how to make the system most costeffective is, according to sources, currently delaying the INESSS report to the Quebec government. "You need to facilitate the government," says Helen- Maria Vasiliadis, a professor of community health at the University of Sherbrooke. "You can't be going to policymakers and showing them billions and billions of dollars. People start having heart attacks. With evidence in hand, we have to present possible solutions."
  • An insurance-based plan is the proposal that has emerged from the Quebec-based CAP group, which sent its proposal to Quebec's health minister last month. In its design, the system would work much like Quebec's public drug plan - Quebeckers not covered through work plans would contribute to a provincial insurance program for therapy. That would be similar to the system that Germany has used for decades. One step forward, one step back
  • Last year, the Sherbrooke clinic where Marie Hayes works received provincial funding for a part-time psychologist and a full-time social worker. With a roster of 25,000 patients, the clinic team laid out clear guidelines for the psychologist, who would consult on cases and screen patients, and be limited to a mere four sessions of actual counselling with any one patient. "We wanted to be careful she didn't become a waiting list - like everything in the system," says Dr. Hayes. The social worker helps guide patients into services such as housing and addiction counselling. They have also offered group sessions for depression management at the clinic. As stretched as those new professionals are in such a large practice, Dr. Hayes says the addition of that mental-health team is improving the care she can provide patients. Recently, for instance, the 32- year-old mother with anxiety attended sessions with the psychologist. "She is making progress," says Dr. Hayes, "slowly."
  • At Women's College Hospital in Toronto, Dr. Grundland is not so lucky. Asked to describe a difficult case, the family-practice physician mentions a patient suffering from depression after a lifechanging accident. Every month, doctor and patient would repeat the same conversation they'd already had more than a dozen times - and make little real headway. Her patient, says Dr. Grundland, needs a trained therapist: someone she can see regularly, to help her move past her frustration, counsel her about addiction, and ease the burden on her family.
  • But there's no extra money in the patient's budget for a psychologist. "I do my best," Dr. Grundland says, "but it's not my area of expertise." Meanwhile, the patient isn't getting better, and in the time that it takes to make it through one appointment with her, Dr. Grundland could see three other people with problems she was actually trained to treat. "But," says Dr. Grundland, "she has nowhere else to go." Erin Anderssen is a feature writer at The Globe and Mail. OPEN MINDS How to build a better mental health care system
  • The Centre for Addiction and Mental Health has purchased advertisements to accompany this series. While CAMH professionals are quoted in this story, the organization had no involvement in the creation or production of this, or any other story in the series. $20.7-billion The cost, according to a 2012 Conference Board of Canada report, of lost productivity each year due to mental illness. What else does $20-billion represent?
  • $20B: Canadian spending on national defence, 2012-13 $20B: Market valuation of Airbnb, 2015 $21B: Kitchener-CambridgeWaterloo region's GDP, 2009 $21B: Amount food manufacturing contributed to the economy, 2012
Govind Rao

Fired workers caught in tangled web of loopholes; THIRD OF FOUR PARTS Ontario's outdate... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150518|220709726

from heather staffing health and safety Ontario legislation standards

shared by Govind Rao on 19 May 15 - No Cached
  • Toronto Star Mon May 18 2015
  • Showed up to work one day and got fired for no reason? Sorry about your luck. In Ontario, not a single worker is protected from wrongful dismissal under the Employment Standards Act. Hit with the flu and can't make it into the office? Consider sucking it up, because chances are you won't get paid. You'll be lucky to keep your job, in fact. Have to put in extra hours one week to get the job done? Whatever you do, don't expect overtime pay - or even to get paid at all.
  • Ontario's outdated employment laws, currently under review, were designed to create basic protections for the majority of the province's non-unionized workers. Instead, millions are falling through the gaps created by a dizzying array of loopholes, from the dangerous to the downright bizarre. Construction workers have no right to take breaks on the job. Care workers aren't entitled to time off between shifts. Vets aren't entitled to vacation pay. Janitors have no right to minimum wage. Cab drivers aren't entitled to overtime pay.
  • ...14 more annotations...
  • And dozens of occupations, some that you've never even heard of, are exempt from basic rights entirely. "Keepers of fur-bearing mammals" have no right to minimum wage. Sod layers have no limits on their daily hours of work. Shrub growers don't get a lunch break. The system is so complicated that the Ministry of Labour has developed a special online tool to help decipher who's entitled to what. But as the province reviews its antiquated Employment Standards Act, critics argue that its confusing web of exemptions makes it harder for the so-called precariously employed to defend their rights - and easier for bosses to ignore them.
  • "When you distil it down to what these exemptions are seeking to achieve, really they are to give employers more control over work and more control over wages," says Mary Gellatly of Parkdale Community Legal Services. "It sends the message to employers that they can get away without complying." The Act was first introduced in Ontario in 1968 to set basic work standards, especially for non-unionized employees who don't have a collective agreement to provide extra protections. But there are at least 45 occupations in Ontario that are exempt from a variety of its fundamental entitlements, many of them low-wage jobs in industries where precarious work is rife.
  • The Ministry of Labour says many of the exemptions are "long standing" and related to "the nature of the work performed." But York University professor Leah Vosko, who leads research into employment standards protections for the precariously employed, says exemptions have come at least in part from industry pressure, leaving the Act a "complex patchwork that is difficult for workers and even officials to comprehend." Even when there are clear violations, speaking out can come at a cost. Reprisal is illegal under the Act, meaning bosses can't penalize employees for exercising their workplace rights. But the Act gives workers no protection against wrongful dismissal. Employers do not have to give cause for firing someone.
  • Unionized employees are generally protected by their collective agreements, and workers can sue employers if they think they have been unfairly terminated. But most precarious, low-income employees are not unionized, and most do not have the money to take legal action against an employer, says Parkdale's Gellatly. "It's the big reason why many people can't do anything if they're in a workplace with substandard conditions, because they can get fired without cause." Linda Wang, who worked at a Toronto cosmetics manufacturer for four years, was fired less than two weeks after asking her employer for the extra pay she was owed for working a public holiday. She says no reason was given for her termination. Wang, a mother of two, claims her employer repeatedly bullied her and her colleagues, and says she believes she was dismissed for asking for the wages.
  • She has filed a reprisal complaint with the Ministry of Labour, but Wang cannot afford to take her employer to court. "I feel the system is against workers," she says. "It's in favour of employers." "Whatever job you have, you put so much of yourself into it," adds Gellatly. "The fact that employers can just fire you without a reason is incredibly devastating for folks." The Act also contains significant gaps when it comes to sick leave and overtime. The legislation provides most workers with 10 unpaid days of job-protected emergency leave, which means they can't be fired for taking a day off due to illness or family crisis. Critics call this measure subpar by most standards, since it still causes many workers to lose a day's income for being ill. An estimated 145 countries give employees some form of paid sick leave.
  • "Unfortunately, we stand out for our inadequacy," says Brock University professor Kendra Coulter. But the 10-day protected leave doesn't apply to almost one in three of the province's most vulnerable workers. An exemption that excludes employees in workplaces of fewer than 50 people from that right means 1.6 million workers in Ontario are not even entitled to a single, unpaid, job-protected sick day. Fast-growing, low-wage sectors such as retail, food services and health care are most likely to be exempt according to a recent report by the Workers' Action Centre. While many small businesses voluntarily give their employees paid sick days, the loophole leaves many workers - especially the precariously employed - exposed.
  • Toronto resident Gordon Butler asked his employer, a small construction company in Markham, for one day off work after he sliced his thumb open on the job. He says his boss told him not to come back. "I didn't believe him," says Butler, 44, who has an 8-month-old child. "I tried to plead with him, and he said 'No, too bad.'" "The way it's stacked up right now is there are very few options for people who are in low-wage and precarious work to actually take sick leave when they're sick," says Steve Barnes, director of policy at Toronto's Wellesley Institute, a health-policy think-tank. "They not only have to worry about lost income, but the potential for losing their jobs," adds Brock's Coulter. "It's unkind and unnecessary." The stress caused by the province's meagre sick-leave provisions is compounded by exemptions to overtime pay, to which around 1.5 million don't have full access.
  • As a rule, employees should get paid time and a half after 44 hours a week on the job, according to the Employment Standards Act. But in 2014, more than one million people in the province worked overtime, and 59 per cent of them did not get any pay whatsoever for it, Statistics Canada data shows. This, experts say, is partly because enforcement is poor. But in Ontario, a variety of occupations don't even have the right to overtime pay, including farmworkers, flower growers, IT workers, fishers and accountants. Managers are also not entitled to overtime. Vladimir Sanchez Rivera, a 45-year-old seasonal farmworker in the Niagara region, says he has worked 96-hour weeks doing back-breaking labour picking cucumbers and other produce.
  • We don't have access to protections when we are working in agriculture," he says. "And our employers tell us that." Low-wage workers are even more likely to be excluded from full overtime pay coverage, according to the Workers' Action Centre's research. Less than one third of low-income employees are fully covered by the Act's overtime provisions, compared to around 70 per cent of higher earners, because they are more likely to work in jobs that aren't eligible. Workplaces can also sign so-called "averaging provisions" with their employees, which allow bosses to average a worker's overtime over a period of up to four weeks. That means an employee could work 60 hours one week and 50 the next, but not receive any overtime as long as they don't work more than a total of 176 hours a month.
  • Critics say the measure means more work for less pay, and paves the way to erratic, unpredictable schedules. "That's a huge impact on workers and their families in terms of lost income and having to work extra hours," says Parkdale's Gellatly. "It's certainly not good for workers, for their families, and it's not good for creating decent jobs in terms of rebooting our economy," she adds. For many of the precariously employed, falling through the gaps ruins lives. "Even now, when I think about the working environment, I feel very depressed," says Wang, who, 10 months later, is still waiting for the Ministry of Labour to issue a ruling on her complaint. "I feel panic."
  • Sara Mojtehedzadeh can be reached at 416-869-4195 or smojtehedzadeh@thestar.ca. By the numbers 1.6 million non-unionized Ontario employees with no right to an unpaid, job-protected sick day 59%
  • of Ontario workers who worked overtime in 2014 did not get any pay whatsoever for it 71% of low-wage, non-unionized Ontario employees don't have full access to overtime pay 29%
  • of high-income employees don't have full access to overtime pay Sources: Workers' Action Centre, Statistics Canada Proposed solutions A recent report by the Workers' Action Centre makes a number of recommendations to rebuild the basic floor of rights for workers. The proposed reforms include: Amending the ESA to include protection from wrongful dismissal
  • Eliminating all occupational exemptions to ESA rights Repealing overtime exemptions and special rules Repealing overtime averaging provisions Repealing the emergency leave exemption for workplaces with less than 50 people Requiring employers to provide up to seven days of paid sick leave
Govind Rao

10 Whiniest Complaints From Justice Antonin Scalia After Obamacare Subsidies Win | Alte... - 0 views

www.alternet.org/...-after-obamacare-subsidies-win

from heather US medicare

shared by Govind Rao on 30 Jun 15 - No Cached
  • By Steven Rosenfeld / AlterNet June 25, 2015
  • Court’s 6-3 ruling today upholding Obamacare subsidies delivered through federal exchanges.
  • More than 6.4 million Americans, nearly two-thirds of Obamacare’s recipients, receive monthly subsidies averaging $272.
Govind Rao

Wave of paramedic PTSD prompts investigation; Toronto ombudsman says probe was spurred ... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150703|224088628

from heather ems Ontario mental health health and safety

shared by Govind Rao on 06 Jul 15 - No Cached
  • Toronto Star Fri Jul 3 2015
  • Vince Savoia was past his rookie days as a Toronto paramedic when he rushed into the apartment of Tema Conter, a girl who had been beaten, raped and stabbed 11 times in 1988. Beneath a white sheet, he found the dead girl naked, her arms and legs bound behind her and a gag in her mouth. The horrific scene and Conter's uncanny resemblance to Savoia's then-fianceé left him crying all the way home that evening and eventually triggered a post-traumatic stress disorder (PTSD) diagnoses years later. In the last two decades, an increasing number of paramedics have followed suit, being plagued with PTSD and other operational stress injuries (OSI). Now, it's time to delve into the problem, says Toronto ombudsman Fiona Crean, who launched an investigation Thursday into how Toronto Paramedic Services (TPS) handles stress injuries among staff.
  • Her investigation announcement follows a (www.paramedicchiefs.ca») report from the Paramedic Chiefs of CanaENDda that found "claims filed with workers' compensation concerning PTSD among paramedic services staff are on the upswing" in some jurisdictions. After repeatedly hearing about the problem, Crean told the Star on Thursday, "I decided I couldn't look at this (issue) any further in an informal fashion." She launched her investigation and made it public so more paramedics would come forward to offer stories and help.
  • ...5 more annotations...
  • She said her investigation was prompted by "a number of complaints" detailing concerns about the way psychological problems such as anxiety, depression, alcohol and drug dependence and post-traumatic stress disorder are triggered by paramedic job duties. Among their responsibilities are providing services to people in dire need of medical attention - some well past help - and entering harrowing crime scenes like Savoia encountered with Conter.
  • "I cannot tell you how many times I have responded to a call for a child that was physically abused," Savoia said. "Those types of calls crawl under your skin." The calls can be hard to forget and to talk about, he said. Plus, not everyone is willing to discuss gruesome experiences with staff psychologists or peer-support teams.
  • In response to news of the ombudsman's investigation, TPS chief Paul Raftis said in an email to the Star, that the TPS "welcomes" the investigation and is "actively supporting her office in this matter." The (www.tema.ca») Conter Memorial TrustEND, which Savoia founded as a way to provide mental health support for emergency workers, estimated that between 16 and 24 per cent of these workers will experience PTSD.
  • Many, including former president of the Paramedic Chiefs of Canada Michael Nolan, counted Toronto among the municipalities leading the way when it comes to mental health services for paramedics. Nolan pointed to Toronto's in-house psychologist and peer-support teams as innovative ways that the city is trying to curb operational stress. "There is a lot to be learned from Toronto," he said.
  • Still, Savoia welcomed Crean's investigation, saying, "even if they are doing things right, the investigation will help them learn how to do things better."
Govind Rao

Ontario calls cases of bedsores unacceptable; New minister agrees province must 'streng... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150917|229447266

from heather Ontario ltc quality

shared by Govind Rao on 17 Sep 15 - No Cached
  • Toronto Star Thu Sep 17 2015
  • Ontario's new associate minister of long-term care says she is "saddened and troubled" by photographs of gaping, infected bedsores published in a Star investigation on Wednesday. "This is simply not acceptable," Dipika Damerla said in a written statement. "We must do more to ensure that incidents such as these do not occur." Damerla said she has told the ministry to look at changes to "strengthen" nursing home compliance - the inspections that are supposed to protect the elderly and hold nursing homes to account. Damerla did not say how or when this will be done.
  • France Gélinas, New Democrat health critic at Queen's Park, said the bedsore pictures of 88-year-old Fatemeh Hajimoradi and Dorothy Benson, 93, are a sobering reminder that there's no strict oversight of nursing homes by the ministry or the Ontario Coroner's Office. "There are usually no repercussions, there's no followup and no inquests. It's so disrespectful," Gélinas said. In the case of Hajimoradi, who developed two serious pressure ulcers while in Mississauga's Erin Mills Lodge, the ministry inspector interviewed staff at the home but not her granddaughter, who filed the complaint. Fariza Trinos, a 30-year-old Bay Street sales co-ordinator, didn't know the inspector had discounted her complaint until the Star sent her a copy of its findings.
  • ...1 more annotation...
  • The inspector didn't visit the home until two months after Hajimoradi permanently moved into the hospital. Trinos said the inspector later told her photographs are not considered because of the possibility they could be digitally manipulated. "I feel like they just went in and accepted everything the home said," Trinos said. "We didn't even get a chance to respond." New owners have taken over Erin Mills Lodge, and in an interview an official at the home cited a low incidence of bedsores. mwelsh@thestar.ca
Govind Rao

NHS cuts kill - strike to defend our health service - 0 views

socialistworker.co.uk/...e+to+defend+our+health+service

from heather UK privatization cuts

shared by Govind Rao on 06 Jan 15 - No Cached
  • Nurse Stuart Beddows killed himself—and the ­pressure of work tipped him over the edge.  Stuart worked as a nurse for 15 years in Walsall Manor Hospital’s endoscopy department.  Walsall NHS Trust boss Richard Kirby admitted, “The outcome of the inquest reflected our own internal review that Stuart was experiencing a high level of stress in the workplace.”
  • Tue 16 Dec 2014
  • In just six months acute health trust workers filed more than 4,000 complaints about staff shortages.  They also made over 1,300 complaints about shifts being filled by under-qualified staff. 
  • ...1 more annotation...
  • “The threat of job losses hangs over health workers—the trust says it needs to make ‘savings’ equivalent to 400 salaries. 
Govind Rao

Patients win right to sue for privacy loss; Appeal Court opens door to multimillion-dol... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|tost|20150219|214827437

from heather Ontario hospital privacy court

shared by Govind Rao on 20 Feb 15 - No Cached
  • Toronto Star Thu Feb 19 2015
  • In a potentially precedent-setting decision, the Ontario Court of Appeal granted patients the right to sue hospitals over privacy breaches Wednesday. The unanimous ruling said provincial health privacy laws are not a roadblock to patients who want to seek justice in the courts when hospital workers snoop into their medical records. The decision comes on the heel of a Star investigation into health-related privacy violations and oversights in Ontario's health privacy legislation.
  • "This case is a vindication for all of those victims the Star has been writing about," said Michael Crystal, lawyer for the patients. Wednesday's ruling could have sweeping implications for the province's 155 hospitals as it has given the green light to a multimillion-dollar privacy class action launched against Peterborough Regional Health Centre. The Peterborough hospital would not answer questions from the Star about whether it intends to appeal the ruling to the Supreme Court of Canada, where it would have its last chance to get the case tossed out. A massive privacy breach at the hospital between 2011 and 2012 saw hundreds of patient medical records snooped into and seven staff members fired. The breach included a domestic violence victim who was in hiding and 414 abortion files that were inappropriately accessed by a high- profile anti-abortion campaigner. A group of affected patients launched a $5.6-million privacy class action against the hospital, which in turn fought to have the case thrown out in the Ontario Superior Court of Justice, arguing the courts had no jurisdiction over health-related privacy breaches.
  • ...4 more annotations...
  • The crux of the hospital's argument was that health privacy violations were the sole domain of the privacy commissioner and that the Personal Health Information Protection Act (PHIPA) ousts the jurisdiction of the courts. The Superior Court ruled against the hospital, so it took the fight up to the Court of Appeal, which dismissed the case Wednesday. In its decision, the court said health privacy legislation does not exclude the jurisdiction of the courts. Health privacy laws were tailored to handle "systemic issues rather than individual complaints," the court said. Peterborough Regional Health Centre declined to comment on the decision, saying "this matter remains in litigation before the courts." In a written statement to the Star Wednesday, a Peterborough hospital spokesperson said the centre had a "zero tolerance policy with respect to inappropriate access to medical records."
  • The hospital has 60 days to appeal the decision to the Supreme Court of Canada. Acting Information and Privacy Commissioner Brian Beamish told the Star he was "very pleased" with the ruling. All patients who are victims of privacy violations should have the option of filing a complaint to the privacy office or taking civil action, Beamish said. Under PHIPA, the privacy commissioner's office acts as a watchdog over health institutions, ensuring they are protecting patient information and abiding by privacy laws.
  • There is no evidence linking Wensvoort's ex-husband to the inappropriate access of her record, according to Crystal, her lawyer. The court awarded Wensvoort $24,000 for the legal fees associated with the appeal. Crystal, who is the lawyer for all the Peterborough patients, said the court's ruling grants patients "access to justice. "The highest court in Ontario has spoken and said invasion of personal health information is not something that is simply the domain of the privacy commissioner," he said. "Patients do not have to go through the administrative nooks and crannies of PHIPA legislation to achieve access to justice." If the latest decision is not appealed by the hospital, Crystal said the next step would be setting dates for a motion of certification for the Peterborough case.
  • Privacy commissioners from other parts of Canada told the Star earlier this year that they have noted a rising trend of health-care professionals snooping into private medical records with malicious intent.
Govind Rao

3 former employees sue AIDS Healthcare Foundation, allege kickbacks in $20M Medicare sc... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|wcpa|20150409|218143626

from heather US corruption fraud medicare

shared by Govind Rao on 13 Apr 15 - No Cached
  • Canadian Press Thu Apr 9 2015
  • Weinstein said small incentives for linking people to services and keeping them there are "mainstays of public health interventions." "Not only has AIDS Healthcare Foundation done nothing wrong, our pro-active approach to finding and linking HIV-positive individuals to lifesaving care and treatment is critical to stopping HIV in this country," Weinstein said in a statement. He noted that the federal government and state of Florida formally declined to intervene in the legal action, which he says "speaks volumes about the merits of the case." The lawsuit was originally filed last year, but an amended complaint was brought last week. Former managers Jack Carrel of Louisiana, Mauricio Ferrer of Florida, and Shawn Loftis of New York filed the whistleblower complaint. According to their attorneys, the three were fired after notifying their supervisors about the company's alleged wrongdoing, even though their attorneys said they are protected under the False Claims Act.
Doug Allan

Family sues seniors' home, LHIN over elderly woman's death - 0 views

www.ottawacitizen.com/...story.html

ltc hospitals cuts

shared by Doug Allan on 08 Oct 12 - No Cached
  • legal action is believed to be the first to arise from a now-defunct program, funded by the Champlain LHIN, that was aimed at freeing up beds for surgical and emergency patients at the region’s overcrowded hospitals.
  • Ironmonger was among hundreds of seniors who were discharged from The Ottawa Hospital and Queensway Carleton Hospital to Valley Stream Manor. Until earlier this year, the retirement home on the city’s west side provided temporary beds for the elderly while they waited for permanent spaces in nursing homes.
  • The beds, known as “interim long-term care,” were conceived as a temporary way to relieve the gridlock caused by elderly patients who occupied hospital beds
  • ...9 more annotations...
  • The 50 interim long-term-care beds in a secure unit of Valley Stream were supposed to provide the care of a nursing home in the setting of a retirement home
  • However, from the time the beds were launched in January 2010 until they were phased out earlier this year, the home was dogged by questions about its ability to care for frail and ailing seniors
  • Indeed, a 2010 coroner’s report into Ironmonger’s death, provided to the Citizen, determined that at Valley Stream she was “in a care setting that could not meet her needs.”
  • Because she was paralyzed on one side, Ironmonger depended on Valley Stream staff to feed her and ensure she was getting enough to eat and drink every day, the lawsuit contends.
  • At the time of Ironmonger’s death, the two hospitals, along with the LHIN, provided Valley Stream with $3.6 million annually to fund the interim long-term-care beds and the staff and services that were supposed to go with them.
  • The report concluded with this blunt warning to provincial health officials: “Care of elders requiring LTC (long-term care) is complex and specialized. The use of temporary LTCH (long-term-care home) beds in facilities that are not experienced in this type of care should be discouraged.”
  • However, three weeks after she was transferred to Valley Stream, Ironmonger was rushed back to The Ottawa Hospital. The lawsuit states that a physician diagnosed the comatose woman with severe dehydration, acute kidney failure and digoxin poisoning, which can occur when someone takes a large amount of medication at one time.
  • It was only after her mother’s death that Wickham discovered Valley Stream had received a number of complaints about the quality of its care.
  • TUESDAY: At least two other seniors died under circumstances similar to those of Adele Ironmonger. Why did health officials ignore repeated warnings about seniors’ homes?
  • Doug Allan on 08 Oct 12
     
    Law suit results from program designed to move patients from hospital to retirement homes.
Irene Jansen

Home First program deprives some elderly patients of right to apply for long-term care,... - 0 views

www.ottawacitizen.com/...story.html

ontario home care substitution

shared by Irene Jansen on 14 Nov 12 - No Cached
  • Some seniors are being pushed out of hospital too soon under the province’s Home First policy, says a lawyer who advocates for older people.
  • Jane Meadus, a lawyer with the Toronto-based Advocacy Centre for the Elderly (ACE)
  • “While many patients will do well at home with extra home-care services, there are many who are too sick to be cared for at home.”
  • ...5 more annotations...
  • ACE has received about 250 complaints from across Ontario in the past year, including from Ottawa, about hospital discharges. “Discharge from hospital is the No. 1 issue in our office,” said Meadus.
  • some elderly patients are being “forced” to go home to recuperate without being given the option to apply for long-term care and waiting for a bed while in hospital. And that might violate their legal rights.
  • In other cases, people are being pressured to enter private retirement homes, which can cost $5,000 a month and might not be able to provide the care needed
  • this policy runs contrary to the provincial Long Term Care Homes Act
  • Without being provided with the correct information, they cannot make an informed choice as is required by the law. Hospitals cannot require physicians to discharge before the person can be safely cared for in the appropriate destination.”
Irene Jansen

Residents gave senior, now charged with murder, wide berth - The Globe and Mail - 0 views

www.theglobeandmail.com/...article9849611

Ontario ltc violence staffing

shared by Irene Jansen on 20 Mar 13 - No Cached
  • “Staff did express concerns that this individual was violent,” said Candace Rennick, a regional vice-president of the Canadian Union of Public Employees, which represents workers at the facility.
  • The tragedy has renewed concerns about low staffing at the Wexford. “You’ve got to ask: Where was the staff during all this?” said Matthias Jetleb, a former vice-chairman of the facility’s family council, whose mother lives there.
  • Inspection records at the Ministry of Health and Long-term Care show complaints filed against the residence last year range from failure to have written plans of care for each resident to abusive behaviour by staff.
  • ...2 more annotations...
  • Mr. Jetleb blames politics for the problems arising from short staffing. “I think that this is a tragic consequence of bare-bones funding,” he said.
  • Staff members have complained that they are saddled with an increasing amount of government paperwork and have less time to monitor residents, Mr. Jetleb added.
Doug Allan

Crisis in Care: Update - Infomart - 1 views

www.fpinfomart.ca/...164562062

LTC staffing

shared by Doug Allan on 27 Mar 13 - No Cached
  • Naomi D'Souza was the head of the Wexford Family Council for three years. Documents obtained by "W5" show that the nursing home's management tried to push her out by campaigning against her re-election, a violation of the Long-Term Care Home Act. Naomi knew the victims and she got to know the alleged attacker, Peter Brooks. She said he did get angry, but never saw him act violently.
  • I was afraid of his temper. I didn't want him if he, if there was misguided anger taken out on my mother. And they would all sit and watch TV together until there was an interaction between him and Lourdes, that Lourdes was afraid to go and sit at the TV.
  • Yes. She was very afraid of him. He was on the, on the fifth floor and he was moved to the second floor. That's where my mother and Lourdes were. And then because of complaints of different people, he was then moved to the third floor where Joycelyn was.
  • ...4 more annotations...
  • RINALDO: Do you blame the staff? D'SOUZA: No. The staff had told the management, too, that there was, he was having, showing this aggressive behaviour.
  • THERESA PICCOLO: I don't understand why nursing homes can't be charged with a criminal act when something like this happens.
  • TRACEY MULCAHY: I think as a sector, we need to regroup. We need to speak with the minister of health. We speak with our local health integration units, and what can we do to prevent this from happening?
  • RINALDO: Back then, "W5" did speak to Ontario 's health minister, Deb Matthews, who called Frank Piccolo's attack unacceptable and pledged improvements in long-term care. DEB MATTHEWS: What I can tell you is that I take my responsibility as the minister responsible for care in long-term care homes extremely seriously
  • Doug Allan on 27 Mar 13
     
    RINALDO: Back then, "W5" did speak to Ontario 's health minister, Deb Matthews, who called Frank Piccolo's attack unacceptable and pledged improvements in long-term care. DEB MATTHEWS: What I can tell you is that I take my responsibility as the minister responsible for care in long-term care homes extremely seriously.
Doug Allan

Dirty hospital rooms a top concern for Canadians - Health - CBC News - 2 views

www.cbc.ca/...hospitals-patient-survey.html

shared by Doug Allan on 09 Apr 13 - No Cached
  • "They couldn't keep up with the amount of time she had to go to the washroom [so] she'd have an accident,"
  • Nearly a third of respondents, who included patients, health-care workers and relatives and friends of patients, said hospital rooms and bathrooms were not kept clean. Stories shared by res
  • Stories shared by res
  • ...18 more annotations...
  • Karl Rinas, 61, who was treated for a bleeding ulcer at a Leamington, Ont., hospital last February, says he ended up wiping down the bathroom himself after his complaints about the dried liquid waste he found on the floor and toilet seat failed to get a reaction, but he worried about older, less mobile patients.
  • Despite all her efforts, Martin says she has no doubt that the antibiotic-resistant superbug Clostridium difficile infection her mother contracted soon after surgery was related to the hospital's level of cleanliness.
  • "I know everybody nowadays has to work more with less, but to me, a hospital should be absolutely clean," she said.
  • Of the respondents who wrote into the fifth estate's survey about being harmed in hospital, most said the harm was a hospital-acquired infection such as MRSA and C. difficile.
  • Unlike in the food industry, there are no standardized inspections for cleanliness in hospitals.
  • A World Health Organization report that compared Canada's infection data with that of 12 other wealthy countries found that Canada had the second-highest prevalence (11.6 per cent) of hospital-acquired infections after New Zealand — much higher than that of Germany (3.6 per cent) or France (4.4 per cent).
  • Is outsourcing to blame?Those who work in hospitals have pointed to the increased outsourcing of housekeeping in recent years as one reason behind the decline in hospital cleanliness that patients and hospital workers have observed
  • "There's no question there's been an impact on the quality of cleaning, and you can see that throughout the years as various hospitals have struggled with very high-profile superbug outbreaks," said Margi Blamey, spokesperson for the Hospital Employees' Union (HEU), which represents 41,000 hospital cleaning and support staff in B.C.
  • But health authorities in other countries are moving away from private cleaning services. Four years ago, Scotland reversed its decision to allow outsourcing of cleaning and catering services because it felt private contractors were not doing a good enough job keeping the spread of infections in check.
  • Blamey says as long as housekeeping is done on a for-profit basis, employers will reduce the number of staff and cut corners on staff training and cleaning supplies.
  • The Canadian Nosocomial Infection Surveillance Program is the closest thing to a federal overview that Canada has, but it relies on voluntary reporting by only 54 hospitals in 10 provinces, most of them teaching facilities, which, according to infection control experts, generally have higher infection rates than other acute care hospitals because they tend to see more seriously ill patients.
  • Michael Gardam, who oversees infection prevention and control at the three hospitals that are part of Toronto's University Health Network, agrees that hospitals have fewer resources for housekeeping these days and have to concentrate cleaning on areas that are most likely to transmit bacteria — primarily the surfaces that multiple patients touch.
  • "I probably get more emails about dust bunnies in the stairwells than anything else in the hospital, and yet, we've done that for a reason. You're not going to catch anything from a stairwell, but you're going to catch it from your bed rails," Gardam said.
  • About two-thirds of hospital-acquired infections are preventable, Gardam said, but making a direct link between cleanliness and infection is not as straightforward as it might seem. Some hospital-acquired infections such as ventilator-associated pneumonia or central line-associated bloodstream infections have little to do with the hospital environment and can be controlled through proper protocols around equipment use. But a superbug like C. difficile is a lot trickier because it is hard to pinpoint its source.
  • Increasing cleaning staff on nights and weekends could also help. A typical medium-sized B.C. hospital that contracts out cleaning services has 24 cleaners by day but only four at night, says Blamey, and workers are often not backfilled when ill or on vacation.
  • "Bacteria don't care what time it is," said Gardam.
  • The infection expert says it doesn’t matter whether a private or public entity oversees cleaning; both have had problems with cleanliness. The bottom line is that hospitals generally undervalue the importance of cleaning staff, Gardam said.
  • "People don't really think of them as part of the team, but if you think about how infections are spread in hospitals, they're actually an incredibly important part of the team that goes far beyond just the cosmetic appearance of the room."
  • Doug Allan on 09 Apr 13
     
    CBC story discusses importance of hospital cleaning, and debates demerits of contracting out. 
‹ Previous 21 - 40 of 101 Next › Last »
Showing 20▼ items per page