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Heather Farrow

Canada's Health-Care System Is Failing To Deliver Timely Care To Patients | B... - 0 views

www.huffingtonpost.ca/...ada-health-care_b_9646872.html

privatization waits private clinics

shared by Heather Farrow on 14 Apr 16 - No Cached
  • 04/12/2016
  • Shorter waits for hip-fracture repair, and eight out of 10 Canadians receiving "priority procedures" within government-defined benchmarks.Sounds pretty good, right?However, these highlights from the Canadian Institute of Healthcare Information's (CIHI) annual update of Wait Times for Priority Procedures in Canada are little more than feel-good distractions from the real story: Canada's health-care system is failing to deliver timely care to patients.
  • Fraser Institute's most recent wait times report f
Heather Farrow

Make senior care a priority; New health accord - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20160827|254784412

accord seniors ltc

shared by Heather Farrow on 29 Aug 16 - No Cached
  • Toronto Star Sat Aug 27 2016
  • Canadian health care faces a rare opportunity - and a daunting challenge. Officials at the federal and provincial level are quietly working toward a new national accord with potential to reshape medicare in this country. If properly done, the process will produce a stronger, more efficient health-care system better serving the needs of both the sick and the healthy. Expect the opposite if turf wars prevail; if inadequate funding leaves vital parts of the system starved of cash and if established interests use this opportunity to give themselves a raise instead of investing in better patient care.
  • With negotiations expected to last for several more months, the outcome of this process remains far from clear. But provincial and territorial officials are, at least, talking with a Liberal government in Ottawa elected on a pledge to negotiate a new health pact. That, in itself, marks a welcome change from years of intransigence under former prime minister Stephen Harper. Under his misguided leadership, the federal level disavowed any responsibility for shaping the health-care system. When an earlier $41-billion health accord, negotiated by Paul Martin's Liberals, expired in 2014, Harper refused to do the hard work of negotiating a new deal.
  • ...6 more annotations...
  • Instead, he simply continued existing transfers of money, with annual increases of 6 per cent, to be followed by a reduction, to about 3 per cent, as of 2017. That formula was issued unilaterally, without consulting the provinces. And transfers came with no strings attached, meaning the federal government effectively abandoned leadership in the realm of Canadian health care. It's vital for Ottawa to oversee the evolution of medicare. That's the best way to set shared national priorities and establish universal standards suited to Canadians' 21st-century needs.
  • Prime Minister Justin Trudeau appears to understand this, with his party campaigning on a pledge to "provide the collaborative federal leadership that has been missing during the Harper decade." Key to this is negotiating a new health accord, including a long-term agreement on funding. Now comes the hard part: actually hammering out a deal. The only immediate commitment made by the Liberals was an investment of $3 billion, over four years, "to deliver more and better home care services for all Canadians." But there was no mention of that in the federal budget this spring, a document notable for its lack of attention to expanding Canada's health-care system.
  • Health Minister Jane Philpott explained that promised changes to home care are part of ongoing talks toward a health accord. Fair enough. But it's essential for the federal contribution, in any new deal, to go beyond just this. Ottawa's health-care transfers to the provinces and territories totalled $34 billion last year, about 22 per cent of public spending in this area. At one time it was a 50-50 split. And Canada's provincial premiers, as recently as July, have urged the federal government to cover at least 25 per cent. That seems reasonable to expect from a new accord, especially given growing pressure on Canada's health-care system from an expanding, and rapidly aging, population.
  • One worthwhile change, forcefully advocated by the Canadian Medical Association earlier his week, would be for Ottawa to deliver additional health-care funding through a special "top-up" based on each province's population of seniors. Health transfers are currently issued on a per-capita basis, failing to take into account far heavier costs associated with caring for the aged. This gives provinces with a younger population, such as Alberta, a break while failing to adequately compensate those with more old people, including British Columbia and Ontario.
  • The Conference Board of Canada made a compelling case for a demographic top-up in a report last fall, calculating that it would cost Ottawa about $8.6 billion over five years. Currently, "there are large discrepancies across the country when it comes to the health-care services available to seniors, particularly in pharmacare, home care, long-term care and palliative care," warn authors of the report. "As Canada's population continues to age, this situation is likely to worsen."
  • One goal of a national accord is to eliminate, or at least ease, such discrepancies. To that end, it would make a great deal of sense to introduce some form of demographic top-up. This represents just one opportunity inherent in negotiating a new health accord. It remains to be seen if it will actually be delivered. © 2016 Torstar Corporation
Govind Rao

Eight Ways Privatization has Failed America - 2 views

truth-out.org/...ivatization-has-failed-america

from heather privatization US

shared by Govind Rao on 09 Aug 13 - No Cached
  • Govind Rao on 09 Aug 13
     
    Monday, 05 August 2013 PAUL BUCHHEIT FOR BUZZFLASH AT TRUTHOUT Some of America's leading news analysts are beginning to recognize the fallacy of the "free market." Said Ted Koppel, "We are privatizing ourselves into one disaster after another." Fareed Zakaria admitted, "I am a big fan of the free market...But precisely because it is so powerful, in places where it doesn't work well, it can cause huge distortions." They're right. A little analysis reveals that privatization doesn't seem to work in any of the areas vital to the American public. Health Care Our private health care system is by far the most expensive system in the developed world. Forty-two percent of sick Americans skipped doctor's visits and/or medication purchases in 2011 because of excessive costs. The price of common surgeries is anywhere from three to ten times higher in the U.S. than in Great Britain, Canada, France, or Germany. Some of the documented tales: a $15,000 charge for lab tests for which a Medicare patient would have paid a few hundred dollars; an $8,000 special stress test for which Medicare would have paid $554; and a $60,000 gall bladder operation, which was covered for $2,000 under a private policy....
Heather Farrow

Is pharmaceutical transparency in Canada all just talk? - Policy Options - 0 views

policyoptions.irpp.org/...arency-in-canada-all-just-talk

pharmacare drugs

shared by Heather Farrow on 10 Aug 16 - No Cached
  • Matthew HerderTrudo LemmensJoel LexchinBarbara MintzesTom Jefferson
  • July 12, 2016 
  • ealth Canada has been talking about improving the transparency of information around
  • ...5 more annotations...
  • pharmaceutical drugs for years. The drug regulator has failed to back up that talk with genuine commitment and action.
  • The lack of transparency around pharmaceutical drugs continues to undermine patient safety and public health.
  • Health Canada has offered up several supposed transparency initiatives, but each has failed to deliver meaningful change.
  • Once again, Health Canada is threatening to undo the commitment to transparency in Vanessa’s Law.
  • Yet the first phase will not include any of the key transparency provisions in Vanessa’s Law.
Heather Farrow

Wrong Care in the Wrong Place: Time to Fix Canada's Failing Approach to Chronic Disease - 0 views

www.cfhi-fcass.ca/...ng-approach-to-chronic-disease

hospital cuts emerg research

shared by Heather Farrow on 22 Jun 16 - No Cached
  • 21/06/2016
  • Unnecessary hospitalizations due to chronic disease are reaching the tipping point of seriously harming this country’s healthcare system and do not meet the needs of patients and their families, according to a report by the Canadian Foundation for Healthcare Improvement (CFHI).
Irene Jansen

Arnold Relman. Why the US healthcare system is failing, and what might rescue it. BMJ - 1 views

www.bmj.com/bmj.e3052

us

shared by Irene Jansen on 17 May 12 - No Cached
  • The US healthcare system is by far the most expensive in the world, but it now leaves about 50 million of its citizens totally without coverage and fails to provide adequate protection for millions more. And the quality of care is on average inferior to that of countries that spend much less.
  • No other country is as dependent on relatively unregulated private for-profit insurance plans as is the US. Other advanced countries, such as France and Switzerland, include private insurance plans as a central part of their health system, but these plans are not-for-profit and are much more tightly regulated by government than in the US.
  • About a quarter of all US practitioners are now employed in such groups, which are being formed by independent physician organisations and by hospitals.
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  • In the US medical care has become a huge, competitive industry with many private investors, but with relatively little government regulation. Involving more than $2.7 trillion (£1.7 trillion; €2 trillion), the US healthcare industry now constitutes nearly 18% of our entire economy and it continues to expand.
  • No more than half of the US health economy involves investor owned organisations and institutions, but most of the others (so called not-for-profits) also see themselves as businesses competing for market share, so they act very much like their for-profit, investor owned competitors. Virtually all organisations and many physicians seek to maximise their income.
  • dependence of the US system on private for-profit insurance plans. Numbering in the hundreds, but increasingly being consolidated within a relatively few giant corporations
  • about a quarter of those over 65 have opted to have Medicare pay for their care through private plans
  • private insurance plans comprise a huge and growing industry, with a gross income of more than $800bn. Their profits and business overheads vary considerably but average between 15% and 25% of their premiums.
  • private insurance plans added over $150bn to the cost of healthcare in 2011.6 (The overhead expenses of Medicare are less than 5% of total expenditures.)
  • The recent movement of US physicians into large multispecialty groups suggests that this reorganisation of medical care may already be under way. If this trend continues, it could not only facilitate the enactment of legislation, but also help to make our medical care much more affordable and efficient.
  • bill, the Affordable Care Act (ACA) was passed by the Democratic controlled Congress in March of 2010
  • many liberals, like me, have reservations.9
  • The law does contain major advances but, despite its name, it has no provisions that will reliably control rising costs.
  • group practices can deliver care more efficiently than unorganised physicians in solo or small, single specialty partnership practices who compete for income and depend on fee for service payment.11
  • substantial savings, as well as improved care, can be anticipated when primary care physicians collaborate with specialists in well organised groups
  • With so many physicians employed in multispecialty practices it would be much easier to institute new payment methods that replace insurance based reimbursement for itemised services with tax supported prepaid access to comprehensive care.
  • ↵Angell ME. The epidemic of mental illness: Why? The New York Review, June 23, 2011:20-2.
  • ↵Relman AS. In dire health. The American Prospect2012;23:34-7.
Irene Jansen

Trials and Errors: Why Science Is Failing Us | Magazine - 0 views

www.wired.com/...1

research methods

shared by Irene Jansen on 23 Jan 12 - No Cached
  • more than 40 percent of drugs fail Phase III clinical trials
  • modern science. In general, we believe that the so-called problem of causation can be cured by more information, by our ceaseless accumulation of facts.
  • Every year, nearly $100 billion is invested in biomedical research in the US
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  • David Hume, the 18th-century Scottish philosopher. Hume realized that, although people talk about causes as if they are real facts—tangible things that can be discovered—they’re actually not at all factual. Instead, Hume said, every cause is just a slippery story, a catchy conjecture, a “lively conception produced by habit.” When an apple falls from a tree, the cause is obvious: gravity. Hume’s skeptical insight was that we don’t see gravity—we see only an object tugged toward the earth. We look at X and then at Y, and invent a story about what happened in between. We can measure facts, but a cause is not a fact—it’s a fiction that helps us make sense of facts.
  • our stories about causation are shadowed by all sorts of mental shortcuts
  • when it comes to reasoning about complex systems—say, the human body—these shortcuts go from being slickly efficient to outright misleading
  • causal explanations are oversimplifications
  • the power of statistical correlation, which has allowed researchers to pirouette around the problem of causation
  • statistical significance, invented by English mathematician Ronald Fisher in the 1920s. This test defines a “significant” result as any data point that would be produced by chance less than 5 percent of the time. While a significant result is no guarantee of truth, it’s widely seen as an important indicator of good data, a clue that the correlation is not a coincidence
  • require that we understand every interaction before we can reliably understand any of them
  • we often shrug off this dizzying intricacy, searching instead for the simplest of correlations. It’s the cognitive equivalent of bringing a knife to a gunfight.
  • Although the scientific process tries to makes sense of problems by isolating every variable—imagining a blood vessel, say, if HDL alone were raised—reality doesn’t work like that. Instead, we live in a world in which everything is knotted together, an impregnable tangle of causes and effects
  • 85 percent of new prescription drugs approved by European regulators provide little to no new benefit
  • it’s not just MRIs that appear to be counterproductive
  • an in-depth review of biomarkers in the scientific literature
  • 83 percent of supposed correlations became significantly weaker in subsequent studies
  • we’ve constructed our $2.5 trillion health care system around the belief that we can find the underlying causes of illness, the invisible triggers of pain and disease
  • If only we knew more and could see further, the causes of our problems would reveal themselves. But what if they don’t?
  • We keep trying to fix the back, but perhaps the back isn’t what needs fixing.
  • more than 40 percent of them were later shown to be either totally wrong or significantly incorrect
  • two leading drug firms, AstraZeneca and GlaxoSmithKline, announced that they were scaling back research into the brain. The organ is simply too complicated, too full of networks we don’t comprehend.
  • the R&D to discover a promising new compound now costs about 100 times more (in inflation-adjusted dollars) than it did in 1950. (It also takes nearly three times as long.)
  • According to the Centers for Disease Control and Prevention, things like clean water and improved sanitation—and not necessarily advances in medical technology—accounted for at least 25 of the more than 30 years added to the lifespan of Americans during the 20th century
  • the things we can see will always be bracketed by what we cannot
Irene Jansen

Compass retains hold on Island health contracts - 0 views

www.timescolonist.com/...story.html

cleaning contracting out corporation research bc compass

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Compass Group Canada retains its monopoly over housekeeping and food services at Vancouver Island health facilities, despite the health authority's attempts to dump the contractor.
  • Vancouver Island Health Authority announced Thursday it has renewed its housekeeping contract, worth $10.61 million per year over five years, with Crothall Services Canada, a division of Compass.
  • "There have been some dreadful outbreaks, including C-Difficile and others, at Nanaimo Regional General Hospital and now the company that was responsible for cleaning is essentially getting rewarded with another contract," Krog said.
  • ...8 more annotations...
  • VIHA says the new contract with Crothall raises cleaning standards, increases staffing levels, creates a specialist outbreak cleaning team, enhances monitoring processes and introduces more patient and staff satisfaction surveys.
  • Mike Old, spokesman for the Hospital Employees' Union, said the union supports the decision of the health authority to retain the experienced workers who currently clean the facilities."Our concerns about crushing workloads for cleaning staff have been recognized through a commitment to higher staffing levels in this contract," Old said.
  • Improper cleaning methods and insufficient cleaner strength had a significant effect in an 11-month C-Difficile outbreak at Nanaimo Regional General Hospital that infected 94 people and killed five which started in 2008.
  • Compass employees lacked proper training to use toxic chemicals that caused hair loss, nose inflammation, respiratory problems and skin irritation, according to two failed WorkSafe B.C. inspections issued in 2008 and 2009.
  • Workers used ineffective cleaners. Staff over-diluted bleach cleaner and later needed to switch to a soil-lifting detergent that would remove the virus from surfaces.
  • If the housekeeping fails on any of the new measures during monitoring, financial penalties will be applied.
  • In April last year, VIHA said it was getting rid of Compass and signing a new contract with Marquise to provide housekeeping and food services at residential care facilities on the south Island - Glengarry, Mount Tolmie, Aberdeen, Gorge Road and Priory Hospital - as well as Queen Alexandra Centre for Children's Health and Saanich Peninsula Hospital. But before the ink on the contract was dry, Marquise was bought by Compass.
  • Compass has three of its divisions working in VIHA's contracted sites: Crothall Services, providing housekeeping services; Morrison, providing food services; and Marquise Group, providing both food and housekeeping services in residential care facilities.
Irene Jansen

Flawed, failed, abandoned: 100 P3s, Canadian & International. 2005. - 0 views

cupe.ca/15959

coalition cupe important p3

shared by Irene Jansen on 06 Mar 12 - No Cached
  • The report, Flawed, Failed, Abandoned: 100 P3s, Canadian & International Evidence, documents dubious P3 projects in the health, municipal and education sectors, providing examples in provinces across Canada, as well as in Australia, England, Scotland and Wales. I
Govind Rao

Home care no-show leaves Edmonton senior on floor, soiled - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|233679|cbcn|20130905|177199553

from heather Alberta ltc continuing care home care privatization safety

shared by Govind Rao on 06 Sep 13 - No Cached
  • CBC.CA News Thu Sep 5 2013,
  • An Edmonton woman says she was left alone on the floor of her seniors residence for nine hours after her home-care worker failed to show up.
  • Marie Chamberland, 87, who has lung cancer and failing eyesight, lives at Ottewell Seniors Living facility, which is operated by the Greater Edmonton Foundation.
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  • Home-care workers with the private company CBI Home Health give Chamberland medication, take her for meals and give her showers. However, over the Labour Day long weekend, her worker did not show up.
Govind Rao

Report Exposes "Discrimination" Against Frail, Elderly Patients - 0 views

www.marketwired.com/...l-elderly-patients-1883271.htm

from heather ontario cupe hospital campaign cuts

shared by Govind Rao on 28 Feb 14 - No Cached
  • Abandoned at home elderly have borne brunt of cuts to hospitals
  • PERTH, ONTARIO--(Marketwired - Feb. 26, 2014)
  • The province's near 20-year fixation with cuts to Ontario hospitals including the closure of 19,000 beds and decreased access to in hospital restorative convalescent care, is resulting in human tragedies on a grand scale, with many patients, foremost the elderly pushed out hospitals while acutely ill with little access to care at home, a report released today in Perth has found. The report, Pushed Out of Hospital, Abandoned at Home: After Twenty Years of Budget Cuts, Ontario's Health System is Failing Patients found it is the elderly and those in smaller communities who are being hurt most by hospital downsizing. Making the situation worse is the under-resourcing of care at home under an "outpatient" community care model that the report shows, is failing miserably.
Govind Rao

The big lie - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|233683|sjet|20130810|175209518

from heather federal medicare accord ally union

shared by Govind Rao on 13 Aug 13 - No Cached
  • Govind Rao on 13 Aug 13
     
    The Telegram (St. John's) Sat Aug 10 2013 Page: A19 Section: Weekend Opinion Byline: Lana Payne Jim Flaherty, Stephen Harper's finance minister, has become a master storyteller. His latest tale, or at least the one his friends are spinning for him, is the deficit was caused by the great recession of 2009. Like every tale, there is a kernel of truth. This new version of history is necessary in order to perpetuate the falsehood that his government is a good manager of the economy. But this is not a deficit the government can blame on the great recession and the subsequent stimulus budget that followed. Rather, Canada's $18.7-billion deficit has it roots in failed economic policies, decisions made before the world financial crisis, including reckless corporate tax cuts. Remember, because the Conservatives would like us to forget, that this is a government that inherited $13 billion in surpluses. They quickly emptied the cupboard with one tax cut after another... We know that governments don't play hardball with big business. Indeed, our federal government saves all the hardball for the provinces. And the biggest piece of hardball is about to unfold over the next year as provinces tie themselves into knots trying to figure out how to pay for health care given the federal government edict. The current health accord ends in 2014 and Harper, with no consultations, has told the provinces to expect a lot less from Ottawa. After all, he has to pay for those corporate tax cuts. No money for health care, but lots for big business. Expect to be told that health care is unsustainable. That we can no longer afford it. Another big lie....
Govind Rao

Victoria fails to act on majority of recommendations from Ombudsperson's report on seni... - 0 views

www.heu.org/...s-report-seniors%E2%80%99-care

from heather bc cupe ltc

shared by Govind Rao on 15 Nov 13 - No Cached
  • Newsletter November 14, 2013
  • The B.C. government has taken action of only six per cent of 176 recommendations to improve seniors’ care made by B.C. Ombudsperson Kim Carter in her landmark report, “The Best of Care: Getting it Right for Seniors in British Columbia”, released in February 2012. A new report from the Canadian Centre for Policy Alternatives in B.C. (CCPA BC) chronicles government response based on an update published by the Ombudsperson’s office in June 2013.
Govind Rao

The national vision that failed - 0 views

www.theprovince.com/...story.html

from heather it

shared by Govind Rao on 07 Oct 13 - No Cached
  • EHealth: Each province doing its own thing has made digitization costs balloon  By Jules Knox, Special To The Province September 24, 2013
  • Billions of taxpayer dollars have been spent on digitization but governments continue to struggle to address the diverse needs of healthcare practitioners. The vision of a pan-Canadian electronic health record for each patient, which once seemed so important, is now further off than ever.
  • B.C. Civil Liberties Association policy director Micheal Vonn is concerned that Canada Health Infoway has an exemption from freedom of information requests related to its spending.
  • ...1 more annotation...
  • When the federal government realized a national strategy was needed, it created Canada Health Infoway, a not-for-profit corporation that has received $2.1 billion since its founding in 2001 to invest in provincial electronic health projects and set pan-Canadian standards for interoperability.
Govind Rao

Family doctors weighing their options; Changes to Bill 20 are welcome, but the buzz amo... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|mtgz|20150530|221592846

from heather Quebec doctors cuts privatization

shared by Govind Rao on 01 Jun 15 - No Cached
  • Montreal Gazette Sat May 30 2015
  • Montreal family physician Fahimy Saoud hated leaving her sick 5-year-old in someone else's care this week, but it was her turn to staffa walk-in clinic and she didn't want to let those patients down. But as the day wore on, Saoud kept hearing her daughter's plea when she left the house: "Who will take care of me?" So on Monday, after seeing everyone in the waiting room, Saoud left the clinic early; her daughter needed her as much as her patients did.
  • She went home thinking of her game plan as the provincial government prepares to pass Bill 20, the controversial carrot-and-stick health reform that Health Minister Gaétan Barrette would soften after alienating many of Quebec's doctors with the threat of clawing back 30 per cent of their salary if they failed meet a patient quota. Barrette announced this week that Bill 20's sanctions would not apply to family physicians for two years - taking the immediate sting out of the bill while keeping the onus on doctors to improve patient access. Which is small comfort to busy family doctors like Saoud.
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  • "I go help mothers with their sick children while I leave mine at home," Saoud said. "I can't see how I can do more." Saoud has three young children. She devotes 60 per cent of her workweek to a Montreal hospital's emergency department - irregular hours that include evening and weekend shifts - while the rest of her schedule is split between a walk-in clinic and what's known as "dépannage," replacing doctors in Quebec's more remote regions at least once a month. What she wants is more time for her job as a mother - helping with their homework and sharing meals - and not have to meet "an impossible" quota of following 1,500 patients, as the original Bill 20 would have required of each family doctor.
  • I am already at my maximum," said Saoud. And so, she has applied for a licence to practise outside Quebec. Nearly 24 per cent of Quebecers are on a waiting list or desperately searching for a family doctor. The crisis is rooted in a 1990s provincial government plan to save money by encouraging doctors to retire early. Staffing shortages ensued, and family doctors were obliged to fill the gaps by working outside their clinics in hospitals and far-flung regions. Quebec has attempted, with little success, to improve primary care over the last two decades by expanding community health clinics (CLSCs) and creating pools of doctors known as Groupes de médecine de famille (GMF) but both limped along under budget constraints and heavy bureaucracy. Barrette contends that the province has more than enough physicians to meet its needs, but that a profound structural change is needed.
  • He presented Bill 20 last fall as his road map to ensure that every Quebecer has a regular doctor. But the bill's punitive measures sparked widespread discontent among doctors against what they called a one-size-fits all, state-controlled, conveyor-belt approach to medicine. Doctors were further incensed at Barrette's assertion that doctors are not productive enough - which they saw as being accused of laziness - and frustrated at being blamed for a broken health system.
  • Like Saoud, many doctors prepared exit plans - from retiring to leaving the province. Some med students, many of whom were actively recruited to shore up Quebec's supply of family doctors, began reconsidering family medicine - or simply leaving to do their residency out-of-province, according to the Fédération des médecins résidents du Québec. Saoud was heading home to her sick daughter on Monday when Barrette announced he had cut a deal with the provincial federation of family physicians to exempt them from Bill 20 - temporarily. There would be no quotas and no penalties, Barrette said, as long as family physicians were able to collectively ensure that 85 per cent of Quebecers had a family doctor by the end of 2017. But Saoud says the change will not keep her here. And she's not alone.
  • The buzz among disillusioned physicians is that "everyone has a Plan B." And while the bill's delay has eased tensions a notch, some doctors are saying the two-year delay simply means they now have until 2017 to prepare a better exit. Bill 20 remains a guillotine above the heads of doctors. "Most definitely, there are physicians investing in Ontario licences and poised to leave if Bill 20 passes. I myself may have to leave," family physician Maggie O'Dell, who works at the Wakefield Family Medical Centre near the Ontario border, said before the bill was modified. And after Barrette backtracked, she had this to say: "It's nice to have reprieve, so it's a relief - for now ... a reason for many to hold back on pulling up stakes in the short term."
  • Doctors are willing to do their part to improve access, O'Dell said, but the Health Department must make participation in the Groupes de médecine de famille (GMF) more attractive by funding electronic records and support staff, and boosting mental health services and long-term beds in nursing homes. Dr. Catherine Duong, president of a collective of 550 general practitioners known by the French acronym ROME, said that the biggest threat of exodus is among doctors who live near the Ontario border. Physicians in that neighbouring province earn, on average, 15 per cent more than those in Quebec, and pay lower income taxes.
  • The group's recent survey - 204 of its members responded - indicated that Bill 20's sanctions would backfire. While the survey was taken three days before Barrette modified Bill 20, Duong said the results reveal that doctors, in particular those whose mother tongue is English, are at risk of leaving the province. Among the 134 francophone doctors polled about their intentions if Bill 20 were applied, 32 per cent said they would resign from hospitals, 12 per cent said they would leave Quebec and another nine per cent would go into private care.
  • Among the 70 anglophone respondents, seven said they already sent letters of resignations to their hospitals (it's not clear whether they are keeping their office family practice) and among the remaining 63 doctors, 34 - more than half - said they planned to leave Quebec. Another seven said they would retire early, seven would move to the private system and three would stop working as family doctors. It's a small sample, Duong conceded, but the study is nonetheless alarming.
  • We are worried that doctors will leave," Duong said, noting that every year, more doctors are opting out of the provincial insurance board (RAMQ), meaning they are no longer on the public payroll, though it's not clear whether they went to private practice or left Quebec. RAMQ representative Marc Lortie confirmed this week that 246 family physicians dropped out of RAMQ between May 2014 and May 2015, up from 204 the previous year and 187 in 2012-2013.
  • In the wake of Monday's announcement to put offBill 20's sanctions, many doctors remain skeptical of Barrette's 85-per-cent target, Duong says, "because it's far too ambitious a goal." Whatever doctors' efforts, Duong says, the reform will fail if the government doesn't help them do their jobs - for example, by abolishing mandatory hospital work. Others suggest the crisis between the province's doctors and Quebec's health minister is over. Bill 20 was heavy-handed, they argue, but if it leads to doctors taking on more patients it will have been a successful negotiating tool. Dr. Yoanna Skrobik, a critical care researcher and adjunct professor at McGill University's department of medicine, is among those who wholeheartedly support the Barrette reform.
  • It's the most dramatic change in the history of Quebec's health system, and the best thing that's ever happened to patients," said Skrobik, who worked side by side with Barrette at Maisonneuve-Rosemont Hospital in the early 2000s, when Barrette was chief of radiology and she was an intensivecare physician. She said that if 85 per cent of Quebecers have a family doctor, the quality of health care in the province will be much improved. Doctors may be offended by Barrette's manner, and by what they see as an attack on their autonomy, Skrobik said, "but it's also true that he puts patient care in the forefront."
  • But Saoud also has priorities. She earned her first medical degree in Haiti, then had to obtain it again after emigrating to Montreal. There's a saying among those who work in the ER, she said: "We know when we go in, but we don't know when we will leave." Saoud, who won the Nadine St-Pierre Award for her research as a resident in family medicine in 2009, still loves being a doctor. "It can be frustrating, but it's really gratifying work. Helping someone is really the cherry on the sundae. But my priority is not that." She would rather not force the children to uproot, but she's skeptical doctors can meet the demands of the health reform. And possible sanctions in two years could force her to to make a tough choice.
  • "My male colleagues don't have that issue. The bill is discriminatory. I'm just asking for the right to be a mother and not simply a doctor." With her permit application process in motion, Saoud says she will go wherever her licence takes her. cfidelman@montrealgazette.com twitter.com/HealthIssues
  • Medical students from four major Quebec universities demonstrate against Bill 20 in March near the legislature in Quebec City. • VINCENZO D'ALTO, MONTREAL GAZETTE / Dr. Fanny Hersson-Edery, left, at a diabetes clinic she runs with nurse Jen Reoch. Hersson has a full schedule, from research to teaching and seeing patients.
Govind Rao

Call for foreign private firms to take over NHS hospitals comes under fire | Society | ... - 0 views

www.theguardian.com/...ospitals-foreign-private-firms

from heather NHS privatization UK

shared by Govind Rao on 03 Jun 15 - No Cached
  • Care Quality Commission boss suggests up to 30 failing NHS trusts could be run by European or American chains
  • Hinchingbrooke hospital, Cambridgeshire, which is run by a private health firm, was cited by the CQC boss as a model that other hospitals could follow. Photograph: John Robertson
  • The ex-Conservative MP who chairs the health service care regulator is under fire after calling for foreign private health firms to be allowed to take over failing NHS hospitals. David Prior, the boss of the Care Quality Commission (CQC), said European or American "hospital chains" should be given the chance to turn around what he said could be as many as 30 NHS hospital trusts in England that have run into trouble by the end of 2014.
Govind Rao

Private MRI clinic told B.C. man he was fine before his serious stroke - British Columb... - 0 views

www.cbc.ca/...e-his-serious-stroke-1.3076099

from heather private clinics privatization bc diagnostics quality safety

shared by Govind Rao on 19 May 15 - No Cached
  • Case raises serious questions about delays, conflicts and mistakes in public-private health care
  • May 18, 2015
  • Stroke victim Peter Peczek believes mistakes and delays in the "failing" health-care system wrecked his life. "I felt I was just pushed over. Next — your 15 minutes is up," said Peczek. "I just needed somebody to take me seriously." The B.C. man said he couldn't get in to see a neurologist or get an MRI at a hospital. Then, a private MRI clinic failed to detect his life-threatening condition.  
  • ...1 more annotation...
  • "An opportunity for stroke prevention was missed, and a stroke that might have been prevented turned out to be quite bad," said Ontario neurologist Bryan Young, who reviewed the case.
Govind Rao

Costly hospital mergers have not delivered solutions to failing trusts, says report | T... - 0 views

www.bmj.com/...bmj.h5090

from heather hospital UK mergers cuts privatization

shared by Govind Rao on 25 Sep 15 - No Cached
  • BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h5090 (Published 24 September 2015) Cite this as: BMJ 2015;351:h5090
  • Gareth Iacobucci
  • The NHS in England has spent £2bn (€2.74bn; $3.06bn) on 12 hospital mergers over the past five years that have largely failed to resolve the problems they were intended to deal with, a report from the King’s Fund has found.The report from the healthcare think tank1 found that most of the £2bn committed by the Department of Health to initiate the mergers had been spent on tackling historical debts and covering deficits and capital investment rather than on delivering the service changes required to make the merged organisations sustainable.
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