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Irene Jansen

Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Inc... - 1 views

www.plosmedicine.org/...10.1371%2Fjournal.pmed.1001244

privatization quality costs excellent

shared by Irene Jansen on 31 Mar 13 - No Cached
  • Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector
  • Irene Jansen on 31 Mar 13
     
    Summary by Anna Marriott, Oxfam Access and responsiveness * Studies that measured utilization by income levels tended to find the private sector predominately serves the more affluent. In Colombo, Sri Lanka, where a universal public health service exists, the private sector provided 72% of childhood immunisations for the wealthiest, but only 3% for the poorest. * Waiting times are consistently reported to be shorter in private facilities and a number of studies found better hospitality, cleanliness and courtesy and availability of staff in the private sector. Quality * Available studies find diagnostic accuracy, adherence to medical management standards and prescription practices are worse in the private sector. * Prescribing subtherapeutic doses, failure to provide oral rehydration salts, and prescribing of unnecessary antibiotics were more likely in the private sector, although there were exceptions. * Higher rates of potentially unnecessary procedures, particularly C-sections, were reported at private facilities. In South Africa for example, 62% of women delivering in the private sector had C-sections, compared with 18% in the public sector. * Two country studies found a lack of drug availability and service provision at public facilities, while surveys of patients' perceptions on care quality in the public and private sector provided mixed results. Patient outcomes * Public sector provision was associated with higher rates of treatment success for tuberculosis and HIV as well as vaccination. In South Korea for example, TB treatment success rates were 52% in private and 80% in public clinics. Similar figures were found for HIV treatment in Botswana. Accountability, transparency and regulation * While national statistics collected from public sector clinics vary considerably in quality, private healthcare systems tended to lack published data on outcomes altogether. Public-private partnerships also lacked data. * Several reports ob
Govind Rao

Privatization: what it is, why it matters - Infomart - 0 views

www.fpinfomart.ca/...223358003

from heather NL privatization union

shared by Govind Rao on 23 Jun 15 - No Cached
  • The Telegram (St. John's) Tue Jun 23 2015
  • With oil prices down, an aging population and high unemployment, the conservative government of Newfoundland and Labrador is looking for a silver bullet to cut costs for public services and infrastructure. Their sights are settling on privatization to be that silver bullet. What is privatization? In its most narrow sense, privatization is the whole or partial sale of public services and/or infrastructure. It can include the sale of assets, functions or the entire institution.
  • With privatization, the service or infrastructure becomes funded and/or run by a private corporation. Privatization usually includes not only a change in ownership but also a change in the priorities, responsibilities and role of the state. Advocates of privatization offer free-market competition as the path to economic and social success, with promises of cost savings, lower risk, greater efficiency and more individual choice. Privatization takes several forms in Canada, including:
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  • ? full privatization: where a government enterprise is sold in full to private investors. ? publicly funded with services and management delivered privately, sometimes unknown to the consumer. ? public funding of private services: government provides vouchers to consumers for the purchase of goods and services from private providers.
  • ? public/private partnerships (P3s): full outside contracting, management and service delivery of traditionally delivered public services such as hospitals, roads, schools and prisons. This can include private finance, design, building, operation and possibly temporary ownership of an asset. Can privatization deliver? After decades of experimentation with privatization in different forms across Canada, the data is clear on the failure to deliver on its promises and the high cost society pays - multiple costs, not only in economic terms but also quality and access to services, quality and quantity of jobs, as well as transparency and accountability.
  • Public/private partnerships (P3s) are the fastest-growing model of privatization in Canada. The P3 models vary but all include the reliance on private sector borrowing to finance the development of public infrastructure projects in a long-term lease arrangement; it is effectively leasing rather than owning and sometimes that lease includes maintenance as well. P3s cost more. Governments have always been able to borrow money more cheaply than private corporations. According to a University of Toronto study of 28 P3 projects in Ontario, P3s cost, on average, 16 per cent more than a traditional public contract. A recent auditor general of Ontario report found that P3 projects cost the province $8 billion more than if they were done under the traditional model.
  • If they cost more, why do politicians promote them? Political expediency - in P3 lease agreements the debt stays off the books or is postponed for decades. P3s hide debt - which is a dream for politicians looking for easy wins in hard economic times. It is also ideological and it is about private sector lobbying and influence. Public services are a boon to private sector deliverers with guaranteed public payments and profit margins over the long term. Supporters of privatization claim that it leads to better pricing for the public as consumers. A comparison of privately owned Manitoba Telecom Services, privatized in 1997, to SaskTel, Saskatchewan's publicly owned telecommunications crown corporation shows this to not be true. Twenty years after privatization of MTS, the cost of a basic phone with SaskTel is $8 less per month than from MTS.
  • Private corporations demand a shroud of confidentiality in order to protect their competitive position. This means that privatization reduces both transparency and accountability. An example of this is the Ontario privatization of municipal water testing which has been linked to the May 2000 bacterial contamination of municipal water in Walkerton, Ont., led to the deaths of at least seven people and the serious illness of 2,300 more from water contaminated with E. coli. The absence of criteria governing quality of testing, and the lack of provisions made for notification of results to authorities contributed to the worst public health disaster involving municipal water in Canadian history.
  • Health care is a sector where there is huge pressure on government to control cost, particularly in Newfoundland and Labrador with the aging demographic. Private interests see great profit opportunities. But in health care, for-profit does not deliver. In Manitoba, living in a for-profit long-term care facility increased the odds of dying in hospital or being hospitalized.
  • In a metadata analysis of hospitals in the U.S., Dr. Philip Devereaux, a cardiologist at McMaster University, concluded that the death rate in for-profit hospitals was two per cent higher than in not-for-profit facilities. In Alberta, the Health Quality Council of Alberta's Long Term Care Family Experience Survey in 2012 found that, on average, private and volunteer operated facilities offered poorer quality in terms of staffing levels, care of residents' belongings, and assistance with daily living activities such as toileting, drinking and eating, than publicly operated ones.
  • The scathing Ontario auditor general report indicates that there needs to be extensive and comprehensive reviews of provincial privatization projects. Until proper cost-benefit analyses and public reviews and reform of private funding and procurement models occur, governments and public bodies should place moratoria on further public-private infrastructure contracts. The citizens pay either way, but they pay more in a privatized model - either as tax payers or out of pocket.
  • The government has alternatives. The Newfoundland and Labrador Federation of Labour has published a number of reports and fact sheets on the progressive revenue options open to the provincial government. There are a variety of progressive revenue options open to municipalities as well. There are no silver bullets. It is time to stop stigmatizing government and public services and recognize them for what they are: the way we pool our resources to buy services cheaper, control costs, and maintain accountability for quality.
  • his should be a debate based on evidence, not ideology. Mary Shortall, president, Unifor Local 597
Govind Rao

Contracting out of surgical preparation and delivery - 2 views

www.ochu.on.ca/contracting_out.php

from heather cupe ontario hospital private clinics privatization

shared by Govind Rao on 24 Nov 14 - No Cached
  • Contracting Out Hospital Work to Private Clinics – Backgrounder For years CUPE has been concerned the Ontario government would transfer public hospital surgeries and diagnostic tests to private clinics. CUPE began campaigning in earnest against this possibility some years ago with a tour of the province by British Health Secretary Frank Dobson who talked about the disastrous British experience with private surgical clinics.Unfortunately, the provincial Liberal government has now moved in this direction. The door opened a few years ago with the introduction of fee for service hospital funding (sometimes called Activities Based Funding). Then in the fall of 2013 the government announced regulatory changes to facilitate this privatization, with the government finally announcing Request for Proposals for the summer of 2014.
  • Hospitals are the main focus of the government’s health care cuts. They do not see community hospitals as providing a broad range of services to the local ... [Read More]population, but instead wish to remove an untold range of services from local hospitals and transfer them to specialized private clinics. The proposal would remove the most lucrative, high volume and easiest procedures from community hospitals. The remaining community hospitals would be left with the most difficult services. If they chose to compete with the private clinics, they would have to specialize in a narrow range of services. The government’s plan is the opposite of one-stop, integrated public health care. This proposed privatization of surgeries and diagnostic tests is in addition to the aggressive attempts to remove non-acute care services from hospitals (e.g. outpatient clinics, complex continuing care, rehabilitation, long-term care, primary care, etc.). As acute care currently accounts for only about 1/3 of current hospital funding, these attacks are a grave threat to the viability of community hospitals, and in fact we are now seeing a wave of hospital shut-downs that is somewhat reminiscent of the Mike Harris era. Despite the government’s rhetoric about keeping care non-profit, services that are being cut from local hospitals now are being privatized to for-profit owned corporations. Even if the private clinics did start out as non-profit (which has not been the case so far) the whole system of private clinics could be privatized with a stroke of a pen.
  • Ontario Health Care Privatization: The push for health care privatization in Ontario picked up in 2001 when Ontario Health Minister Tony Clement announced two privatized P3 hospital projects, the Royal Ottawa and the Brampton Civic (part of William Osler Health Centre). Spirited community-based campaigns, including P3 plebiscites in many towns, forced the Liberal government to greatly narrow the scope of the privatization of support jobs (i.e. CUPE jobs) in subsequent P3 hospitals. Nevertheless privatization of the hospital financing continues, despite revelations by the provincial Auditor General that confirmed claims by CUPE and others that the Osler project cost hundreds of millions more due to the P3.
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  • MRI and CT Clinics: The PC government also tried to set up private MRI and CT clinics outside of hospitals. Community/labour campaigns however were able to stop this. A key factor was that, to increase their revenue, the private clinics were allowed to bill private patients for a certain number of hours each week (with the rest of the week dedicated to patients paid for by the public system). As the public insurance system must pay for all ‘medically necessary’ hospital services, the government was left to try to explain why any reputable clinic would allow patients to subject themselves to such tests for medically unnecessary reasons. Since this episode, private clinics have been in the news – but mostly for the wrong reasons. Private surgical and diagnostic clinics: Initially, the government let the emerging industry slip entirely free of public reporting and oversight. However, after the September 2007 death of Krista Stryland, a young mother who underwent liposuction at a Toronto cosmetic clinic, the government required the industry to face some modest oversight in 2010. Unfortunately this was not by a public authority, but through self-regulation by the doctors (even though the doctors themselves had lobbied to expand this private industry).
  • Then in the fall of 2011, following disclosure that 6,800 patients would have to be notified that faulty infection control procedures at a private clinic could have exposed them to HIV or hepatitis, the then Health Minister, Deb Matthews, declined to introduce oversight by a public authority, despite public pressure. Instead she comments, “Government can’t do everything. A professional (regulating body) like the College of Physicians and Surgeons, they take responsibility for their members....At this point I am delighted the College is taking that responsibility seriously and has found a problem that we need to fix.” Eventually the College of Physicians and Surgeons released a report on the private clinics that mentions that some 29% of the private clinics fall short in some way – but the College would not indicate which ones – or how they fell short. This caused public uproar, with the Toronto Star playing a leading role (as it would continue to do). Again, the government promised improvements. In the last two months however, the Star has followed up and revealed (after our urging) that the public reports from the College of Physicians and Surgeons fall far short. They also ran a series of often front page stories on serious quality problems at private clinics.
Govind Rao

Private-public partnerships a misplaced fascination - Infomart - 0 views

www.fpinfomart.ca/...210311455

from heather p3 ontario fraud

shared by Govind Rao on 12 Dec 14 - No Cached
  • Waterloo Region Record Fri Dec 12 2014
  • On Tuesday, provincial auditor general Bonnie Lysyk zeroed in on just one element of the pathology - the government's overweening urge to have private-sector firms design, fund, construct and manage public projects. The government refers to these as alternative financing and procurement schemes. It says they save taxpayers money. Do they? Lysyk looked at 74 public-private projects started since 2005 to answer that question. She found that, in total, they cost $8 billion more than if they had been built and managed by the government alone. In one telling example, she looked at the construction of two near-identical buildings for an unnamed Mississauga college. The first, handled by the public sector, was completed on time and on budget. Over the objection of both the college and then mayor Hazel McCallion, the government decreed that the second building be funded and handled by a private project manager. When the figures are adjusted for inflation and other variables, that second building is expected to cost taxpayers 10 per cent more per square foot. The reason is straightforward. Big projects are always built with borrowed money. And governments can borrow far more cheaply than private firms.
  • Ontario's Liberal government has an almost pathological desire to involve the private sector in public business. When awarding contracts for new power plants, it has favoured private electricity firms over publicly owned Ontario Power Generation. It insists that large-scale public construction projects, such as hospitals, be handled by private firms paid from the public purse. It is anxious to contract out the delivery of public medicare services to private clinics. For a while, it even privatized regulation, giving industry groups the authority to charge consumers fees for handling electronic and other kinds of waste. In one notorious case, the Liberal government established an arm's-length public agency called Ornge to run the province's air ambulance service. Then, inexplicably, it allowed this agency to set up a web of privately owned, profit-making subsidiaries. Finally, someone has blown the whistle.
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  • Private project managers also tend to charge higher legal and management fees. As well, they must return profits to their owners. Aficionados of public-private partnerships insist that while all of this may be true, privately managed projects are far more likely to come in on time and under budget. That is the argument used by Infrastructure Ontario, the body charged with handling public-private deals. It says that if the 74 projects had been handled by the public sector, delays and overruns would have cost taxpayers - in net terms - about $6 billion more. It also says that publicly managed projects are five times more likely to come in over budget than privately managed ones. Is any of this true? Lysyk is not convinced. She points out that Infrastructure Ontario has no empirical evidence to back up its claims and instead bases them on the judgment of outside advisers who, her report says, make their case "anecdotally" and tend to cast publicly managed projects "in a negative light." She also notes that Infrastructure Ontario's initial cost estimates for public-private partnerships are systematically inflated. One result (which she is too polite to mention) is that private-public schemes usually appear to come in under budget. That makes everyone look good.
  • The Liberals may be the grand priests of private-public partnerships. But they are not the only ones to embrace this particular theology. In the 1990s, Bob Rae's New Democratic Party government famously arranged for a private consortium to finance, build and operate Highway 407, largely to avoid saddling the province with $1 billion more in debt. Yet in the end, the Rae government had to borrow the $1 billion itself - and then pass it on to the consortium. The private-sector partners just couldn't raise the cash as cheaply. Little has changed since then. On the face of it, public-private partnerships seem a good way to save money. In reality, as Lysyk has confirmed, they usually cost taxpayers more. Thomas Walkom is a news services columnist.
Govind Rao

Privatization accelerated under Sask Party: report - Infomart - 1 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|sasp|20151009|231005549

from heather Saskatchewan privatization research

shared by Govind Rao on 09 Oct 15 - No Cached
  • The StarPhoenix (Saskatoon) Fri Oct 9 2015
  • A policy think tank is bringing attention to what it sees as an "acceleration" of privatization under the Saskatchewan Party, something the deputy premier dismisses as "fearmongering." A new report by the Saskatchewan office of the Canadian Centre for Policy Alternatives documents what it considers to be more than 50 instances of privatization, or at least announced plans for it, in the past decade, from the sale of Crown subsidiaries to public-private partnerships to the contracting out of public services. The office's director and report author, Simon Enoch, called the reco d "quite substantial - a lot more than I think the average citizen would suspect."
  • Enoch said that despite studies showing strong public support for Crown corporations, the "subterranean privatization agenda going on really hasn't seemed to activate the public." He suspects that's because much of the privatization that's occurred has been below-the-radar, such as that of the Information Services Corporation or hospital laundry services. He said the issue is likely to pick up steam as the government wades into more well-known areas like liquor stores and MRIs. "I would fully expect to see them attempt a major privatization should they win a new mandate in the next election," Enoch said. The trend hasn't gone unnoticed by the Saskatchewan Federation of Labour. Its president, Larry Hubich, said the report "reaffirms what we've known. We've been saying for quite a while that there's a creeping privatization agenda that's almost being carried out in stealth." He added that privatization is "risky and costs taxpayers more in the long run."
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  • In that vein, Enoch said in the report that accountability and transparency have been the first victims of privatization in Saskatchewan. "What it also means is that hard-working Saskatchewan people are losing good jobs," Hubich said. The report argues that in many instances, privatization has not delivered on the promises of "lower-cost, yet also higher-quality and more responsive services than the public sector." NDP MLA Trent Wotherspoon agreed the government seems to "use privatization at every turn," which he called short-term thinking that is not in the best interest of the province, driving up the cost of living and giving away quality jobs. "There's a large and growing concern across Saskatchewan about what's next," he said.
  • Deputy premier Don Mc-Morris dismissed the report as "fearmongering." "The basis of their argument is all around fear, trying to scare people to think that nobody else can deliver these services except government employees," he said. "That just isn't the record here in Saskatchewan or really anywhere else in North America." McMorris touted the growth Saskatchewan has seen under his party. "We'd never want to go back to the type of thinking that this organization is trying to profess," he said, referring to the idea that "privatization is an absolutely terrible word." He emphasized as one example how surgical wait lists have decreased with privatization. "They would have rather had people languish on long wait-lists than actually do something about it by using the private sector," McMorris said of the centre.
  • Privatization hasn't "necessarily" accelerated under the Saskatchewan Party, and future moves will be dictated by a common-sense approach, he said. While the report noted that several jurisdictions in Canada and around the world are bringing privatized sectors back into the public realm, McMorris pointed to the growing popularity of public-private partnerships in North America. "I wouldn't say jurisdictions are backing away," he said. McMorris was hesitant to say whether privatization would figure large in the 2016 provincial election, but Hubich and Wotherspoon said they think it will be a lightening rod. "I actually think it will define the next election," Enoch said. nlypny@leaderpost.com twitter.com/wordpuddle
Govind Rao

Expansion of surgeries at private clinics faces delays; Many details must be worked out... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|vasn|20150611|222488543

from heather private clinics surgery bc privatization legislation

shared by Govind Rao on 23 Jun 15 - No Cached
  • Vancouver Sun Thu Jun 11 2015
  • A provincial proposal to shrink surgical waiting times by letting private surgery clinics do more complex operations could take up to two years to implement, says the registrar of the College of Physicians and Surgeons of BC. That's because of changes to legislation that may be required to allow private facilities to keep patients for up to three nights and other changes to ensure they are more like hospitals, with security guards, full meals, a variety of health professionals, labs, imaging suites and even intensive-care units. Currently, the college allows private facilities to do procedures requiring a maximum one-night stay. "We applaud the minister of health for thinking outside the box to address the issue of access to care," said the registrar, Dr. Heidi Oetter, referring to the idea of expanding publicly funded access to private facilities. The proposal is in a Health Ministry discussion paper.
  • In an interview, Oetter said expanding the types of surgeries the province pays for at private clinics is not easy to sort out quickly. "There's a role for the private facility sector. But this requires an extensive review," said Oetter, adding it could take from 18 to 24 months. The government has set up a Surgical Services Secretariat that will work with the college on changes to laws and procedures to enable longer stays in private facilities, if that direction is chosen.
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  • While private facilities like the Cambie Surgery Centre and the Centric Health Surgical Centre (formerly False Creek Surgical Centre) consider themselves hospitals, the college makes a distinction and Oetter said private facilities are inspected and accredited for one-night stays only. "We think of them as private facilities, not hospitals. When you think of hospitals, you think of 24-hour staff, security guards, meals and so on," she said.
  • Cambie has five operating rooms plus a dental procedure suite and seven private post-op recovery rooms. He said whether the facility is a hospital or not is really a matter of semantics. "Think about all the tiny community hospitals around B.C. and you can see that we are far more advanced and closest to the best hospital in B.C. Our staff are all the best you can get." Day said Cambie has been inspected and approved not only by the college but by the national body that audits and accredits hospitals - Accreditation Canada. Such accreditation isn't mandatory, but college approval is required.
  • About 50,000 people pay for their procedures themselves each year in private facilities. Renee Hourigan, spokeswoman for Centric, declined to comment. Dr. Brian Day, owner of the Cambie Surgery Centre, said it would be easy to accommodate patients for longer periods and to meet any new requirements. "We're not going to hire a chef, but we already provide snacks and meals to patients. We give them menus and they choose what they want and the food is delivered."
  • There are nearly 80,000 adults and children waiting for surgery in B.C. hospitals and median waiting times have not changed in several years despite reforms. According to the policy paper, 90 per cent of elective surgery patients got their surgery within 40 weeks in 2013/14, while the rest waited longer. In 2013/14, 5,503 publicly funded operations were performed in private facilities, down from the 7,839 cases performed in private clinics the year before. Another 541,886 scheduled (elective) operations were done in B.C. public hospitals. There are about a dozen private surgery centres in B.C. offering a range of operations, general anesthetics and overnight stays.
  • About 700 B.C. surgeons have privileges to work at private surgery centres. Under B.C. law, any facility where surgeons work must be inspected and accredited by the college to ensure high standards of care and patient safety. Sarah Plank, a spokeswoman for the Health Ministry, said the government is analyzing what kind of cases might be suitable for funded private surgery centres. The process is in the early stages so a timeline of up to two years is "not unreasonable," she said.
Govind Rao

Province enlists private surgery clinics; $10M plan for up to 1,000 procedures takes ai... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|vasn|20150602|221789192

from heather bc private clinics privatization

shared by Govind Rao on 02 Jun 15 - No Cached
  • Vancouver Sun Tue Jun 2 2015
  • B.C. is turning to private clinics to help ease a massive backlog of surgeries, even as it prepares to fight a court battle against private medicine. Health Minister Terry Lake announced $10 million on Monday to push through common surgical procedures - orthopedics, hernias, cataracts, gall bladder, plastic surgery, and ear, nose and throat procedures - for those waiting more than 40 weeks. The extra money will be used to conduct up to 1,000 new surgeries, some of which will be done in private clinics when there are no available operating rooms in public hospitals.
  • Vancouver Coastal Health said it expects to fund 350 additional surgeries, including day surgeries conducted in leased private operating rooms. Fraser Health said it would provide 500 extra procedures over the summer. "About one per cent of the surgeries done in British Columbia are actually done in private clinics but paid for publicly," said Lake, who described an "unprecedented demand" and unacceptable waiting times facing the public system. "We want to see if we can optimize that. I think patients want to have their surgeries done. If the quality is there, and it reduces wait lists and is paid for and administered by the public system, I think British Columbians would agree with that approach."
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  • The announcement comes as the provincial government prepares to defend itself in a lawsuit filed by Brian Day, an orthopedic surgeon, co-owner of the Cambie Surgery Centre and 2016 presidential candidate for Doctors of B.C. Day contends in his suit that patients should have the constitutional right to pay for care in private clinics if waits in the public system are too long.
  • "I think this is a good initiative. I think it's, in a way, brave of the government to do this when it's involved in a lawsuit," said Day. He said the province's announcement did not put it in an awkward position going into the court case, given that "contracting out has been going on for years," but it showed that the public sector is stressed to the point that it cannot handle the workload. "Obviously I support what the government's doing here, but I think there's a touch of hypocrisy going on when they're involved in a lawsuit where they claim that wait lists are not the fault of the hospitals or themselves but the fault of the doctors," Day said. "There are two wait lists.
  • There are the patients waiting for surgery. Then there are the surgeons waiting to be able to do the surgery. ... The surgeons are waiting because they can't get operating time." Day's lawsuit is expected to last seven months and is tentatively scheduled in the B.C. Supreme Court at the end of the year. Under current laws, private clinics are not supposed to collect money from patients if the treatment is an insured service in the public system. Lake said B.C. remains fully against a two-tier health system, but the government has used private clinics in the past and considers many of its physicians to be private health care contractors.
  • "The use of private surgical clinics within the publiclypaid and publicly-administered health care system has always been an important part of the system," he said. Of the 541,885 publicly-funded surgeries in 2013, 14, 5,503 were done in private facilities using public money. The Vancouver Island Health Authority is seeking private clinics to conduct 55,000 day surgeries over five years to ease the pressure on hospital operating rooms.
  • A Health Ministry official said the "cost of doing procedures in a private surgical facility is generally comparable to what it would have cost to do them in a public health care facility" but could not offer a specific comparison. There were almost 72,000 adults waiting for surgery in B.C. at the end of April. Approximately 90 per cent of patients receive surgeries within 33 weeks, according to a government website.
  • The reality is we're still struggling with wait times despite a huge increase in the number of surgeries that we are performing each and every year," said Lake. NDP critic Judy Darcy chastised the government for turning to private clinics when underfunding has left some hospital surgical rooms empty. The government estimates 82 per cent of its 295 operating rooms are fully operational, with the rest unused due to financial or staffing shortages.
  • "It's a very small Band-Aid on a very big problem," said Darcy. "It's yet another short-term fix that shifts services to private clinics rather than addressing the serious problems in the public system." If the province properly funded the public operating rooms it could help retain staff and have a better long-term impact on waiting times than short-term contracts with the private sector, she said.
  • Darcy also accused government of "talking out of both sides of its mouth" by relying on public surgical suites to knock down waiting times while at the same time fighting against them in court. Lake said the $10 million will also be used to "optimize the booking system" for surgeries, which could mean sending a patient to a hospital outside their home city if it has extra capacity in an operating room.
  • He also suggested B.C. could move to a "first available surgeon model" where patients are referred to whoever can conduct the surgery quickest rather than to a preferred surgeon. The government will announce further ways it intends to increase surgical capacity later this year. rshaw@vancouversun.com mrobinson@vancouversun.com
Govind Rao

Clinics a ripoff: critic ; HEALTH: Private health clinics cost more, former UK health m... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|sust|20150916|229381229

from heather cupe Ontario hospital private clinics privatization campaign

shared by Govind Rao on 16 Sep 15 - No Cached
  • The Sudbury Star Wed Sep 16 2015
  • A former health minister from the United Kingdom says he believes "private clinics are a bad option for the people of Canada." Frank Dobson, who was health minister from 1997 to 2000 in Tony Blair's Labour Party government, made a stop in Sudbury on Tuesday. Dobson was invited by the Ontario Council of Hospital Unions (OCHU) to speak about the pitfalls of privatization of health-care services in the United Kingdom. He is visiting eight other communities in the province to give his take on health-care privatization and how it may affect the health-care system in Ontario. "I wouldn't recommend the British model to anyone because it has basically been a rip off," Dobson said.
  • "The money going into running the system (in Britain) has gone up from between four and six per cent of the total National Health Service spending to somewhere between 12 and 15 per cent of NHS spending going on this semi-commercial system and that is somewhere around 8 billion pounds a year extra going on the cost of running the services (that are) not going on patient care, Dobson said. Dobson also provided other examples of why the system is flawed in the Britain.
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  • "The problems we found is the private sector genuinely believe they will be more efficient and when they discover they can't be much more efficient than our National Health Service, or for that matter, your public health services here, they have to start cutting back on standards and in quite a number of cases now in Britain, they've taken over a franchise (clinic) and can't make a go of it, so then hand it back because they can't cope with actually running a decent service," Dobson said. He also said that drawing up contracts with private clinics is complicated and costly. "The people creating the contract try to cover every eventuality in the contract, and they need to do that because in Britain we had a case where a woman had a major hemorrhage in a small hospital and they didn't have an emergency blood supply, so they sent someone to the nearest NHS hospital to get some blood.
  • "By the time they got back, the woman had bleed out and died. When (officials of private clinic) were pressed about this, they said, 'Oh well, it didn't specify in the contract that we had to have an emergency blood supply,'" Dobson said. He said the contracts "have to be water tight, and it means legions of lawyers, accountants and management consultants" drawing up contracts and "that is money that is not going" into patient care.
  • Kevin Cook, of OCHU, who is travelling with Dobson, said that the Canadian Union of Public Employees and OCHU oppose the Ontario government's plans to expand the use of private specialty clinics to deliver services currently being provided by local hospitals. "First of all, this isn't about the job losses (with our members), this is about patient safety and the patients come first," Cook said. "We are concerned with infection control issues" ... there are different measures in hospitals then there are in private clinics. Hospitals have an infection control team, they have the department that cleans the instruments, then it goes to the doctor, so there is a different chain within the private clinics.
  • "They are not going to have the same standards" as a hospital, Cook said. Cook gave an example of how things can go wrong in a private clinic. In September 2007, a patient bled to death undergoing liposuction surgery at a private clinic in Ontario. The tragedy happened a few months after Dobson visited Ontario and cautioned the provincial government on allowing private surgery and procedure clinics to open in Ontario. "We are asking the Ontario government to stop the private clinics. It is not cheaper; it will cost us in the long run. And they keep saying it is a savings, but it is not," Cook said.
  • Dobson agreed. "The thing I try to get across is this ... everyone in Canada knows that you spend, roughly speaking, half as much as the Americans spend in their health-care system. So the idea that a competitive system like theirs is cheaper, doesn't make a lot of senses. And it also means that the private sector is trying to come in and take over what is essentially in Canada and Britain, a very, very, cost-effective health-care system. "Always remember, with private businesses, their primary duty is to provide their shareholders with profit," Dobson said. sud.editorial@sunmedia.ca
  • Frank Dobson, right, a former health minister in the United Kingdom, spoke to reporters about the pitfalls of private clinics during a visit to Sudbury on Tuesday. Looking on is Kevin Cook, of the Ontario Council of Hospital Unions.
Govind Rao

Private clinics don't work: ex-health secretary; Britain's Dobson warns against moving ... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|hbsp|20150915|229291500

from heather privatization private clinics Ontario cupe hospital campaign

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  • The Hamilton Spectator Tue Sep 15 2015
  • A former British health secretary is warning Ontario not to push surgeries out of hospitals and into private clinics after an effort to do the same ended with "dismal failure" in the United Kingdom. Attempts to have the private sector deliver public services has ended with abandoned contracts, increased costs, compromised care and a growing roster of consultants promoting enterprising clinics to government, Frank Dobson says. "There's a sort of huge, rather sleazy industry now that are people who worked in the National Health Service who are now running private clinics," the retired MP said during a stop in Hamilton on Monday.
  • Union representatives acknowledged job losses are a concern, but their overriding issue is the quality of patient care. "We are looking at this government to make changes and make a commitment to stop their private clinics from happening and put the patients first," Kevin Cook, OCHU regional vice-president, said at a news conference at the Barton Street East legion Monday. The province hasn't yet "shifted low-risk procedures to out-of-hospital clinics," Ministry of Health and Long-Term Care spokesperson David Jensen wrote in an email.
  • ...4 more annotations...
  • Private enterprise hasn't made health care more efficient, but rather more sluggish, the longtime Labour Party politician said. Bloated corps of lawyers, accountants and consultants hired by government now fret over tenders and contracts, which must be watertight, he noted. Dobson cited one case in which a woman suffering from a serious hemorrhage bled out during surgery because the private clinic didn't have an emergency blood supply. "The answer from the clinic was the contract didn't say we had to have an emergency blood supply," he said. Dobson is touring Ontario cities with officials from the Ontario Council of Hospital Unions (OCHU) and CUPE to discourage provincial plans from bringing more surgeries and procedures into the private fray.
  • However, with the shift, the ministry hopes to provide patients with "quicker access to complex surgeries because hospitals will be able to get to more complex procedures sooner." Ontario hospitals have struggled to do more with less in an era of cost-cutting and provincially mandated, balanced budgets. But giving private operators a bigger piece of the pie won't lower wait times nor reduce costs, said Dr. Wayne Taylor, executive director of the public policy think-tank Cameron Institute. "I don't see any value added in having something privately owned or publicly owned if it's still government money. What we need frankly is private-pay health care so that people have a choice." However, firms aren't exactly chomping at the bit to delve into health care, the former McMaster professor added, calling it a low-return investment.
  • Many MRI operators in Ontario dropped off the map about a decade after they set up shop, he noted. "Half of them are still around. Half of them went out of business." A number of private clinics in Hamilton provide OHIP-insured services, such as the Hamilton Endoscopy Centre on James Street South, Pain Care Clinics - Hamilton West, on Main Street West, and the Hamilton Vein Clinic on Upper Wentworth Street. Dobson argues private-sector imperatives and health-care needs are strange bedfellows, recalling how earlier this year one firm operating a U.K. hospital threw in the towel when its care fell under scrutiny and business looked bad. That was Circle Health, which gave up running Hinchingbrooke Hospital after three years because it was "no longer viable," the BBC reported. "The ultimate discipline in a market is if you can't make a go at it, you go bust, and it closes down. Well, you can't allow it to close down because patients need to be looked after," Dobson said.
  • Taylor, however, who calls the National Health Service a "disaster," says the private-public operating debate is a "red herring." He has heard of some "quality issues" at privately run colonoscopy clinics. If a doctor punctures a colon at a hospital, there's backup, Taylor said, but, in private clinics, "I don't know." Success depends on proper regulation, Taylor said. The Liberal government has come under scrutiny for not providing adequate oversight of private clinics, notably after a bacterial outbreak at a Toronto pain clinic in 2012 went unpublicized as it infected nine patients there.
Doug Allan

Reforming private drug coverage in Canada: Inefficient drug benefit design and the barr... - 0 views

www.healthpolicyjrnl.com/...fulltext

drugs benefits

shared by Doug Allan on 04 Feb 15 - No Cached
  • Reforming private drug coverage in Canada: Inefficient drug benefit design and the barriers to change in unionized settings
  • The Canadian Life and Health Insurance Association, concerned about the sustainability of private drug coverage in Canada, has asked for government help to reduce costs [11x[11]Canadian Life and Health Insurance Association, Inc. CLHIA report on prescription drug policy; ensuring the accessibility, affordability and sustainability of prescription drugs in Canada. Canadian Life and Health Insurance Association Inc., ; 2013See all References][11]. Growing administrative costs of private health plans continues to put additional financial pressures on the capacity to offer private health benefits [12x[12]Law, M., Kratzer, J., and Dhalla, I.A. The increasing inefficiency of private health insurance in Canada. Canadian Medical Association Journal. 2014; 186See all References][12].
  • Most Canadians are covered through private drug plans offered mostly by employers through supplemental health benefits: 51% of Canadian workers have supplemental medical benefits [2x[2]Morgan, S., Daw, J., and Law, M. Rethinking pharmacare in Canada. CD Howe Institute, ; 2013 (Commentary 384)See all References][2], and since work-related health insurance also covers dependents of employees with coverage, as many as two-thirds of Canadians are covered by health insurance plans.
  • ...17 more annotations...
  • Prescription drug spending in Canada's private sector has increased nearly fivefold in 20 years, from $3.6 billion in 1993 to $15.9 billion in 2013 [3x[3]Express Script Canada. 2013 Drug trend report. ESI, Mississauga; 2014 (http://www.express-scripts.ca/sites/default/files/uploads/FINAL_executive%20summary_FINAL.pdf [accessed 01.06.14])See all References][3].
  • Private drug plans in Canada are often considered wasteful because they accept paying for higher priced drugs that do not improve health outcomes for users and use costly sub-optimal dispensing intervals for maintenance medications. As a consequence, it is estimated that private drug plans in Canada wasted $5.1 billion in 2012, which is money spent without receiving therapeutic benefits in return [4x[4]Express Scripts Canada. Poor patient decisions waste up to $5.1 billion annually, according to express script Canada. (June)Press release, ; 2013 (http://www.express-scripts.ca/about/canadian-press/poor-patient-decisions-waste-51-billion-annually-according-express-scripts [accessed 01.06.14])See all References][4]. This amount represented 52% of the total expenditures of $9.8 billion by private insurers on prescription drugs for that year [5x[5]Canadian Institute for Health Information. Drug Expenditure in Canada 1985 to 2012. CIHI, Ottawa; 2013See all References][5].
  • Respondents from all categories mentioned that, in contrast to employers, the over-riding objective of unions is to maximize their benefits with minimal co-payments for their employees.
  • The study focused on large unionized workplaces that had Administrative Services Only (ASO) plans, where the employer is responsible for the costs of benefit plans and bears the risks associated with it, while insurers are just hired to manage claims.
  • This study focused on ASO arrangements because they are the most common insurance option chosen by large private-sector firms [16x[16]Sanofi. Sanofi Canada healthcare survey. Rogers Publishing, Laval; 2012See all References][16]. Those organizations whose activities resided solely in the province of Québec, where the regulation of private drug plans differs [17x[17]Commissaire de la santé et du bien être du, Québec., Les médicaments d’ordonnance: État de la situation au Québec. Gouvernement du Québec, Québec; 2014See all References][17], were excluded.
  • Respondents from all categories indicated that consistency of benefits with other market players is of significance to employers.
  • Sean O’BradyxSean O’BradySearch for articles by this authorAffiliationsÉcole de relations industrielles, Université de Montréal, Montreal, Quebec, CanadaInteruniversity Research Centre on Globalization and Work (CRIMT), Montreal, Quebec, Canada, Marc-André GagnonxMarc-André GagnonSearch for articles by this authorAffiliationsSchool of Public Policy and Administration, Carleton University, Ottawa, Ontario, CanadaCorrespondenceCorresponding author at: School of Public Policy and Administration, Carleton University (RB 5224), 1125 Colonel By Drive, Ottawa, Ontario, Canada K1S 5B6. Tel.: +1 613 520 2600.xMarc-André GagnonSearch for articles by this authorAffiliationsSchool of Public Policy and Administration, Carleton University, Ottawa, Ontario, CanadaCorrespondenceCorresponding author at: School of Public Policy and Administration, Carleton University (RB 5224), 1125 Colonel By Drive, Ottawa, Ontario, Canada K1S 5B6. Tel.: +1 613 520 2600., Alan Cassels
  • Finally, employers were most concerned with the government's role in distributing the costs associated with drug coverage among public and private players in the system. In fact, each employer expressed concern over this. Three of the four employers expressed concern over the government's role as a plan sponsor and how governments shift costs to the private sector. As described by one employer, “the government is a very big consumer of drugs” and if the drug companies “start losing money on the government side, they pass it on to private insurance”. Thus, government regulations that help employers contain costs are desired.
  • the employer always has the advantage in this stuff because they have all of the information with respect to the reports and the costs from the insurer or the advisor”
  • According to one consultant, “no one knows the cost of drug benefit plans.” This respondent was arguing that few involved in benefit design, either in private firms, unions, or insurers, are sufficiently competent to undertake proper analyses of claims data so they do not really know how proposed plan changes could affect them. This lack of expertise has ramifications for the education of stakeholders on the outcomes of benefit design.
  • However, when speaking of for-profit insurers, participants from all groups argued that insurers have no financial incentives to cut costs for employers, as indicated by one employer saying: “from my experience on the committees, I don’t get the impression that the insurers are there to save costs for the employers. I haven’t seen it. It's always been the other direction.” This claim was also corroborated by a benefits consultant, who argued that “there has been a fair bit of inertia, you know, amongst the providers out there in actually doing something too radical, too leading edge” because “there's no direct financial incentive for insurance companies or pharmacy benefit managers to actually help employers save money”.
  • Expanding on this, another consultant argued that an insurer's commission structure, which is based on volumes of claims expressed in a dollar value, may in fact discourage insurance companies from proposing plan designs that reduce the volumes of claims, as doing so would adversely affect company profits. Furthermore, another benefits consultant indicated that insurers are experts who calculate risk and thereby have no aptitude for the creation of formularies. According to this respondent, the impact is that insurance companies excel at managing risk, yet fare poorly in designing cost-effective plans that rely on the design and implementation of formularies.
  • An interesting finding from the interview data was that respondents from all interviewed groups declared being in favor of introducing some sort of arrangement for a national drug plan. Some favored having a universal pharmacare program which would apply to all drugs, while others favored programs tailored for catastrophic drug coverage. Two of the insurers that responded to this question explicitly favored some form of universal catastrophic drug coverage while the other favored universal pharmacare.
  • Each of the union representatives and one employer interviewed for this study expressed their support for universal pharmacare. Three out of five consultants argued in favor of a national pharmacare plan while the other two favored some other form of national risk pooling or formulary management to address costs.
  • While a majority of interviewees favored some form of universal coverage, a few respondents from the insurer and employer sides expressed concerns that universal pharmacare is not feasible.
  • The employers indicated that their over-riding strategy is to maintain cost-neutrality in providing drug benefits – in the context of overall compensation – to employees: any increases in the costs of a particular benefits area must be off-set by cost-savings elsewhere. Controlling knowledge was also frequently reported by the union-side respondents (and by one consultant that services employers) as a strategy to achieve greater control over negotiations and plan design by firms. According to one union representative, “
  • Marc-Andre Gagnon has received research funding by the Canadian Federation of Nurses’ Unions for a different research project related to drug coverage in Canada. Alan Cassels is co-director of DECA (Drug Evaluation Consulting and Analysis). The authors would like to acknowledge the financial contribution of the Canadian Health Coalition in order to pay for the transcription of interviews.
Heather Farrow

Kenney, Hoffman spar over private health care option; PC leadership hopeful calls for m... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|cahr|20160816|253937793

conservatives privatization private clinics

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  • Calgary Herald Tue Aug 16 2016
  • Oh, no. We're into it again - back to the endless, arid Alberta debate on public versus private health care. Jason Kenney, the early bird unofficial Progressive Conservative leadership candidate, said Monday he thinks Albertans deserve more health options, on the models of Quebec and British Columbia. Kenney was answering questions about the Herald story that revealed MRI wait times in Calgary are up 20 per cent. Too many people are on the list who don't belong there, and the machines are idle too much of the time. "I think there needs to be more flexibility in the way the system is administered," Kenney told the CBC's David Gray.
  • "It means allowing people more options like the model in Quebec, which is universal and complies with the Canada Health Act." The interviewer asked if that means more private care. "As long as it's competition within the public system and everybody gets access to quality health care, I don't see any reason why Albertans should have less
  • ...6 more annotations...
  • choices than British Columbians or Quebecers do," answered Kenney. Health Minister Sarah Hoffman has an answer: if Kenney wants a policy brawl over the injection of more private options, he's welcome to it. "I'm not surprised that he's trying to find ways to expand privatization in the health-care system," she said in an interview. "Certainly, that's unfortunate." As you'd expect from a federal Conservative, Kenney blames centralized decision-making. "I just believe that local management of resources is a lot more sensible than hyper-centralized control," he told the Herald. "You know, when hospitals are given a limited budget for a limited number of hours they can service people, that gets out of alignment with the actual local demand."
  • But Hoffman figures Albertans don't want another major shift in how health care is run, after watching a pack of failed experiments in the PCs' waning years. She has doctors and officials working on two related problems - how to get more use out of the city's publicly owned MRI machines, and how to make sure everyone on the list really needs the test. I asked if she eventually plans to fold the province's vast array of private clinics, including imaging centres, under the government wing through public ownership.
  • We're not planning on doing a full overhaul," she said. "In general, Albertans are proud of what we've got. I don't have any drastic plans for changing the way those programs are administered." As often happens, when you sift through the rhetoric the opponents are quite close together. Most New Democrats would agree with another Kenney statement (as long as they're weren't aware who said it): "We need to ensure our health care has adequate funding, that it's publicly administered, that it's universally available, that it complies with the Canada Health Act." The key point is not who owns the assets, but who pays the bill. If health care pays, it hardly matters whether you get the test in a public hospital or a private clinic.
  • The MRI dispute is a good example of how the public-private debate has become so futile and misleading. Nine MRI machines in Calgary are publicly owned. They perform the tests for people on the waiting list. But there are also three MRIs in privately owned clinics.
  • The province doesn't fund MRI tests in those private clinics. The PCs wouldn't, and now the NDP won't either. And yet, health care funds virtually every other imaging test, including X-rays, ultrasounds and mammograms. Those exams are done every day in the very same clinics that own the private MRIs. The cost of a private test is $750, which probably explains why those machines are underused despite the long public wait.
  • Simple answer, right? The province should just start funding tests on the private MRIs. Asked why she doesn't do that, Hoffman says, "Why would you pay to rent something when you already own it and you're only using it half the time?" OK then, why not use what you've got? Why does that have to be so ridiculously difficult? Health care in Alberta is extraordinarily complex, and because of that, far beyond the reach of simplistic rhetoric about private and public delivery. That debate is just a distraction from the real issue - making the system work. Do that, please. Don Braid's column appears regularly in the Herald dbraid@postmedia.com
Govind Rao

Management of hospital food, cleaning services to be privatized by this fall - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|frdg|20150702|223990315

from heather NB food cleaning privatization hospital

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  • The Daily Gleaner (Fredericton) Thu Jul 2 2015
  • The Liberal government plans to have a deal by fall to see a private firm take over the management of food and cleaning services in the province's hospitals. The Liberals have signalled that they want to give the private sector a greater role in the province's health-care system. Health Minister Victor Boudreau announced in April that government had started negotiating with a private firm to deliver some services in both health authorities. That direction was reinforced by Horizon Health Network CEO John McGarry earlier this week, who has now suggested the use of private health-care firms could pull physiotherapists, audiologists, dietitians and other outpatient services from hospitals. The government confirmed on Tuesday that it soon expects to ink a deal with a private provider.
  • We are still in current discussions with the preferred proponent and we hope to have completed the process sometime this fall," said Health spokesman Bruce Macfarlane in an email. Macfarlane stressed that the contract is "only outsourcing the management of the services." "CUPE staff will remain in their union and will continue to be employees of the province of New Brunswick," he added. Boudreau has said that the move will save the province millions of dollars through efficiencies brought in by a private company. The government maintains that change is needed.
  • ...6 more annotations...
  • "New Brunswickers have been very clear - change is necessary and government needs to get its fiscal house in order," Macfarlane said. "We can no longer continue with the status quo. "We are undergoing a strategic program review to look for efficiencies and to uncover programs or services that could be changed or discontinued as well as find sources for revenue." McGarry said in a speech to the Rotary Club of Saint John in the Port City on Monday that a needed ideological shift in health care should see even greater use of private health-care firms.
  • "I think there are opportunities for the private sector to get more involved in our system in the things that we don't do as well as we should," he said. "Publicly paid, but privately delivered, contracted. "Do some of the services we provide under a public system really belong in the public system?" McGarry specifically cited outpatient services. "If you look at hospitals these days, you find so many ambulatory care services that are in the hospital system," he said. "Sometimes there is a private provider out in the community.
  • We have physio, there is private physio. We have audiologists, there are private audiologists. We have dietitians, there are private dietitians. You start to say, 'How did we ever get into this?' "As we start to shrink our infrastructure, these are the things that pop out." McGarry said the health authority is now at the beginning of five-year plan to redirect $48 million currently being spent on hospital infrastructure.
  • Meanwhile, the government has declined to reveal the prospective proponent of the food and cleaning services contract until a deal is finalized. But CUPE spokeswoman Norma Robinson says the Department of Health has informed the union that food and facilities management giants Sodexo, Aramark and Compass Group are involved in the bidding process. She said the union was told that the government is seeking a 10-year contract, first negotiating with Sodexo, to hammer down a deal within the next three to six months.
  • Sodexo has previously confirmed its interest in the contract to the Telegraph-Journal. Robinson said on Tuesday that questions remain as to what the impact of any deal will be on current public sector workers. "We don't know what this contract is going to look like from the union perspective," she said. "They are saying it's just the management today, but what does that look like when Sodexo gets in here? "What does that look like for the employees of the system."
  • Robinson added: "John McGarry has a five-year health plan that he is rolling out. The government says it's on a fiscal cliff saying there is money to be saved in health care. I think this is the first step to the privatization of health care."
Govind Rao

hospital food services to be privatized by fall - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nbtj|20150702|223990411

from heather NB hospital food privatization

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  • New Brunswick Telegraph-Journal Thu Jul 2 2015
  • FREDERICTON * The Liberal government plans to have a deal by fall to see a private firm take over the management of food and cleaning services in the province's hospitals. The Liberals have signalled that they want to give the private sector a greater role in the province's health-care system. Health Minister Victor Boudreau announced in April that government had started negotiating with a private firm to deliver some services in both health authorities.
  • That direction was reinforced by Horizon Health Network CEO John McGarry earlier this week, who has now suggested the use of private health-care firms could pull physiotherapists, audiologists, dietitians and other outpatient services from hospitals. The government confirmed on Tuesday that it soon expects to ink a deal with a private provider. "We are still in current discussions with the preferred proponent and we hope to have completed the process sometime this fall," said Health spokesman Bruce Macfarlane in an email.
  • ...7 more annotations...
  • "I think there are opportunities for the private sector to get more involved in our system in the things that we don't do as well as we should," he said. "Publicly paid, but privately delivered, contracted. "Do some of the services we provide under a public system really belong in the public system?" McGarry specifically cited outpatient services.
  • "New Brunswickers have been very clear - change is necessary and government needs to get its fiscal house in order," Macfarlane said. "We can no longer continue with the status quo. "We are undergoing a strategic program review to look for efficiencies and to uncover programs or services that could be changed or discontinued as well as find sources for revenue." McGarry said in a speech to the Rotary Club of Saint John in the Port City on Monday that a needed ideological shift in health care should see even greater use of private health-care firms.
  • Macfarlane stressed that the contract is "only outsourcing the management of the services." "CUPE staff will remain in their union and will continue to be employees of the province of New Brunswick," he added. Boudreau has said that the move will save the province millions of dollars through efficiencies brought in by a private company. The government maintains that change is needed.
  • "If you look at hospitals these days, you find so many ambulatory care services that are in the hospital system," he said. "Sometimes there is a private provider out in the community. "We have physio, there is private physio. We have audiologists, there are private audiologists. We have dietitians, there are private dietitians. You start to say, 'How did we ever get into this?'
  • "As we start to shrink our infrastructure, these are the things that pop out." McGarry said the health authority is now at the beginning of five-year plan to redirect $48 million currently being spent on hospital infrastructure. Meanwhile, the government has declined to reveal the prospective proponent of the food and cleaning services contract until a deal is finalized. But CUPE spokeswoman Norma Robinson says the Department of Health has informed the union that food and facilities management giants Sodexo, Aramark and Compass Group are involved in the bidding process.
  • She said the union was told that the government is seeking a 10-year contract, first negotiating with Sodexo, to hammer down a deal within the next three to six months. Sodexo has previously confirmed its interest in the contract to the Telegraph-Journal. Robinson said on Tuesday that questions remain as to what the impact of any deal will be on current public sector workers. "We don't know what this contract is going to look like from the union perspective," she said. "They are saying it's just the management today, but what does that look like when Sodexo gets in here?
  • "What does that look like for the employees of the system." Robinson added: "John McGarry has a five-year health plan that he is rolling out. The government says it's on a fiscal cliff saying there is money to be saved in health care. I think this is the first step to the privatization of health care."
Govind Rao

Funds should be better invested in Canada's public health care system - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|bcvi|20150915|229391583

from heather bc privatization private clinics

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  • Campbell River Mirror Tue Sep 15 2015
  • It is extremely concerning that our provincial government is contracting up to 55,000 surgeries to a private surgery clinic Re: Deal with private contractor could reduce surgery wait times - J.R. Rardon. The above noted article was in the Aug. 26, Campbell River Mirror. Reading the headline I have to ask "but at what cost?"
  • It is extremely concerning that our provincial government is contracting up to 55,000 surgeries to a private, for profit, surgery clinic which is yet to be built. If this company is locating in Victoria they must have received assurance for long term commitments to enable them to locate there permanently. Surgical Centres Ltd. is "based" in Calgary, they have two private, for profit, surgery clinics in Calgary, two in B.C., two in Saskatchewan. Are the owners American?
  • ...5 more annotations...
  • Dr. Brendon Carr (president and CEO of Island Health) when asked at the Island Health Board meeting here in June stated that there will be a premium in cost for the surgeries at the private clinic. We know private, for profit, health care is more expensive. He said they have the information and would provide it, but when I wrote and asked what the difference in cost for the taxpayers between surgeries in public or private, for profit, operating rooms, Mr. Peters declined to answer the question.
  • Our provincial government is seeking to change the BC Health Act to permit patient stays of up to three nights in private, for profit, surgery clinics so their plan into the future is to embrace private, for profit, surgery clinics. In the provincial government's own report it states the reason why our public hospital operating rooms sit idle quite often is due to lack of funding. The government and Island Health think it is okay to contract out these surgeries because the surgeries are still being publicly funded but our taxpayer dollars will be spending more for the profit margin.
  • I pointed out to Dr. Carr that we have a shortage of doctors in Canada and he agreed. He said it would be the same doctors doing the surgeries in the private, for profit, surgery clinics. I asked how they can usurp our doctors into the private system without straining our public system more. He just said they will be watching it. That doesn't bode well for our public operating rooms. I fear that our provincial government is seriously undermining our position in defending the Dr. Brian Day court case on behalf of all British Columbians. At the very least it looks like a huge conflict of interest when they are seeking to contract an enormous number of surgeries to private clinics.
  • Our provincial and federal governments seem determined to starve the public health care system in favour of private, for profit, health care. They have let the surgery wait lists increase substantially. Our federal government refused to renegotiate the Canada Health Accord and brought in a new funding formula. They are telling us they are "increasing"  funding of the transfer payments to the provinces by three per cent, tied to the cost of living. Currently they are paying six per cent annually so this actually is a massive cut to the provinces for public health care in the amount of $36 billion over the next 10 years. With the federal government's cuts to health care funding, the share of federal CHT cash payments in provincial-territorial health spending will decrease substantially from 20.4 per cent in 2010-11 to less than 12 per cent over the next 25 years. This, according to the Parliamentary Budget Office, will bring the level of federal cash support for health care to historical lows. National Medicare was implemented across Canada by provinces and territories on the understanding that the federal government would contribute roughly 50 percent of the spending on Medicare.
  • Canadians are vehemently opposed to private health care whether it is using our public tax dollars or not. Canadians should not have to suffer and wait a long time for surgery. Funds would be far better invested in the public health care system which is being starved by our governments. It is very difficult for Canadians to see our medicare in serious jeopardy. The Canadian Medical Assoc., Canadian Doctors for Medicare, Canadian Health Coalition, Council of Canadians, B.C. Health Coalition, HEU, CUPE, Citizens for Quality Health Care and many others are united to protect, strengthen and expand our public health care. Please check out their websites and get more information. Please vote in the next two elections and vote for health care for the benefit of all Canadians. Lois Jarvis Citizens for Quality Health Care Campbell River
Govind Rao

Private-public partnerships a misplaced fascination - Infomart - 0 views

www.fpinfomart.ca/...210197890

from heather p3 ontario

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  • Toronto Star Thu Dec 11 2014
  • Ontario's Liberal government has an almost pathological desire to involve the private sector in public business. When awarding contracts for new power plants, it has favoured private electricity firms over publicly-owned Ontario Power Generation. It insists that large-scale public construction projects, such as hospitals, be handled by private firms paid from the public purse. It is anxious to contract out the delivery of public medicare services to private clinics. For a while, it even privatized regulation, giving industry groups the authority to charge consumers fees for handling electronic and other kinds of waste.
  • In one notorious case, the Liberal government established an arm's-length public agency called ORNGE to run the province's air ambulance service. Then, inexplicably, it allowed this agency to set up a web of privately owned, profit-making subsidiaries. Finally, someone has blown the whistle. On Tuesday, provincial auditor general Bonnie Lysyk zeroed in on just one element of the pathology - the government's overweening urge to have private-sector firms design, fund, construct and manage public projects. The government refers to these as alternative financing and procurement schemes. It says they save taxpayers money.
  • ...3 more annotations...
  • Do they? Lysyk looked at 74 public-private projects started since 2005 to answer that question. She found that, in total, they cost $8 billion more than if they had been built and managed by the government alone. In one telling example, she looked at the construction of two near-identical buildings for an unnamed Mississauga college. The first, handled by the public sector, was completed on time and on-budget. Over the objection of the both the college and then mayor Hazel McCallion, the government decreed that the second building be funded and handled by a private project manager. When the figures are adjusted for inflation and other variables, that second building is expected to cost taxpayers 10 per cent more per square foot. The reason is straightforward. Big projects are always built with borrowed money. And governments can borrow far more cheaply than private firms.
  • Private project managers also tend to charge higher legal and management fees. As well, they must return profits to their owners. Aficionados of public-private partnerships insist that while all of this may be true, privately managed projects are far more likely to come in on time and under budget. That is the argument used by Infrastructure Ontario, the body charged with handling public-private deals. It says that if the 74 projects had been handled by the public sector, delays and overruns would have cost taxpayers - in net terms - about $6 billion more. It also says that publicly managed projects are five times more likely to come in over budget than privately managed ones.
  • Thomas Walkom's column appears Wednesday, Thursday and Saturday.
Govind Rao

Privatization in health care will leave poor out in the cold - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|wist|20150504|219760378

from heather privatization medicare poverty ally

shared by Govind Rao on 04 May 15 - No Cached
  • Windsor Star Mon May 4 2015
  • A long-running dispute between Dr. Brian Day, the co-owner of Cambie Surgeries Corp., and the British Columbia government may finally be resolved in the BC Supreme Court this year - and the ruling could transform the Canadian health system from coast to coast. The case emerged in response to an audit of Cambie Surgeries, a private for-profit corporation, by the BC Medical Services Commission. The audit found from a sample of Cambie's billing that it (and another private clinic) had charged patients hundreds of thousands of dollars more for health services covered by medicare than is permitted by law. Day and Cambie Surgeries claim the law preventing a doctor charging patients more is unconstitutional.
  • Day's challenge builds on the legacy of a 2005 decision by the Supreme Court of Canada overturning a Quebec ban on private health insurance for medically necessary care. But this case goes much further, not only challenging the ban on private health insurance to cover medically necessary care, but also the limits on extra-billing and the prohibition against doctors working for both the public and private health systems at the same time. A trial date was set to begin in 2012, but was adjourned until March 2015 so that the parties could resolve their dispute out of court and reach a settlement. It now appears such a resolution has not been reached and the court proceedings may resume in November. Here's why this case matters.
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  • Legal precedent: Whatever way the case is decided at trial, it is likely to be appealed and eventually reviewed by the Supreme Court of Canada. A decision from this level will mean all provincial and territorial governments will have to revisit equivalent laws. The foundational pillars of Canadian medicare - equitable access and preventing twotier care - could well be vanquished in the process. Wait times: Day will likely argue that Canada performs poorly on wait times compared to other countries, and that other countries allow two-tier care; thus, if Canada is allowed two-tier care, our wait times would improve. But this approach is too simplistic. Comparisons to the British health system, fail to recall that, despite having two-tiers, it has in the past suffered horrendously long-wait times. Recent efforts to tackle wait times have come from within the public system, with initiatives like wait time guarantees and tying payment for public officials to wait times targets.
  • By looking to Britain, we are comparing apples to oranges. British doctors are generally full-time salaried employees while most Canadian physicians bill medicare on a fee-forservice basis. Consequently, the repercussions of permitting extra billing in Canada could eviscerate our publiclyfunded system, whereas this is not the case in Britain. Imagine if most doctors in Canada could bill, as those at the Cambie clinic have done, whatever they want in addition to what they are paid by governments?
  • Conflict-of-interest incentives: Evidence suggests there is a danger in providing a perverse incentive for physicians who are permitted to work in both public and private health systems at the same time. Wait times may grow for patients left in the public system as specialists drive traffic to their more lucrative private practice. Sound improbable? Academic studies have noted this trend in specific clinics that permit simultaneous private-public practice. And recent U.K. news reports have profiled a case where a surgeon bumped a public patient in need of a transplant for his private-pay patient.
  • Competition: Proponents of privatized health services often claim it would add a healthy dose of competition, jolting the "monopoly" of public health care from its apathy. But free markets don't work well in health care. Why? Because public providers and private providers won't truly compete if the laws Day challenges are struck down. Instead, those with means and/or private insurance will buy their way to the front of queues. Public coverage for the poor will likely suffer, as is clearly evident in the U.S., with doctors refusing to provide care to low-income patients in preference for those covered by higher-paying private insurance.
  • Of course, this is all based on an outcome that is not yet known. It may be that the charter challenge in B.C. will be unsuccessful, but clearly the stakes for ordinary Canadians are high. Sadly Dr. Day is not bringing a challenge for all Canadians. Isn't it past time our governments and doctors work to ensure all Canadians - and not just those who can afford to pay - receive timely care? Colleen Flood is Professor and University Research Chair in Health Law Policy at the University of Ottawa. Kathleen O'Grady is a Research Associate at the Simone de Beauvoir Institute, Concordia University and Managing Editor of EvidenceNetwork. ca
Govind Rao

Province in talks with health-care contractor; union raises concerns - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nbml|20150923|229859350

from heather NB hospital privatization cupe

shared by Govind Rao on 23 Sep 15 - No Cached
  • Miramichi Leader Wed Sep 23 2015
  • The province expects to have completed talks with a private contractor for the management of health-care cleaning and food services before the end of the year. Bruce McFarlane, Health Minister Victor Boudreau's director of communications, said that the province is "still in current discussions with the preferred proponent and we hope to have completed the process sometime this fall." McFarlane sent The Daily Gleaner an email statement Friday afternoon after the New Brunswick Council of Hospital Unions CUPE local 1252 released a 20-page document critical of the government's plan to privatize housekeeping, food services and porter services at hospitals. "We want to clarify that we are only outsourcing the management of the services," said McFarlane, who added that the ministry had not yet received the document.
  • CUPE staff will remain in their union and will continue to be employees of the Province of New Brunswick." Norma Robinson, president of CUPE Local 1252, said she is "very concerned that the Liberal government is negotiating with a private firm to take over the management of food and cleaning services in the province's hospitals." Robinson said she's worried the move could lead to further privatization. In an interview with Brunswick News in April, Boudreau said the government wants to give the private sector a greater role in the province's health-care system.
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  • Boudreau has said the move will save the province millions of dollars through efficiencies brought in by a private company. However, the union's document paints a poor picture of privatization of services in health-care facilities in other jurisdictions. "We believe it is important for New Brunswickers to understand the impact of such a move, especially when it comes to the cleanliness of a building which the public relies on everyday," Robinson said. Last year, the Horizon Health Network started a regular audit of the cleanliness of hospitals being serviced by unionized public sector workers. Auditor General Kim MacPherson reported that health-care workers weren't cleaning their hands as required and that the standards to do so weren't even the same within the two regional health authorities.
  • Robinson said Friday that policies have been established and changes made that are addressing cleanliness concerns. "And they have improved on their targets of cleaning in the hospital sector," she said. The union claims its research into the three companies they believe are being considered to take over those services - Sodexo, Aramark and Compass - shows a poor track record. The union said it's also concerned about the quality of food declining. The union wants to keep the management of hospital environmental services in-house. It also wants fair wages and benefits for cleaning and food services staff to ensure against high turnover and gaps in training. The union also stated lay-offs and staff reductions would be a poor way to balance the budget.
  • "The cost associated with treating hospital-acquired infections, managing public relations fiascoes and defending lawsuits would defeat any possible savings while destroying the public trust." The Province of New Brunswick expects to have completed talks with a private contractor for the management of health-care cleaning and food services before the end of the year.
  • Bruce McFarlane, Health Minister Victor Boudreau's director of communications, said Friday that the province is "still in current discussions with the preferred proponent and we hope to have completed the process sometime this fall." McFarlane sent The Daily Gleaner an email statement Friday afternoon after the New Brunswick Council of Hospital Unions CUPE local 1252 released a 20-page document critical of the government's plan to privatize housekeeping, food services and porter services at hospitals. "We want to clarify that we are only outsourcing the management of the services," said McFarlane, who added that the ministry had not yet received the document.
  • "CUPE staff will remain in their union and will continue to be employees of the Province of New Brunswick." Norma Robinson, president of CUPE Local 1252, said she is "very concerned that the Liberal government is negotiating with a private firm to take over the management of food and cleaning services in the province's hospitals." Robinson said she's worried the move could lead to further privatization. In an interview with Brunswick News in April, Boudreau said the government wants to give the private sector a greater role in the province's health-care system.
  • Boudreau has said the move will save the province millions of dollars through efficiencies brought in by a private company. However, the union's document paints a poor picture of privatization of services in health-care facilities in other jurisdictions. "We believe it is important for New Brunswickers to understand the impact of such a move, especially when it comes to the cleanliness of a building which the public relies on everyday," Robinson said. Last year, the Horizon Health Network started a regular audit of the cleanliness of hospitals being serviced by unionized public sector workers. Auditor General Kim MacPherson reported that health-care workers weren't cleaning their hands as required and that the standards to do so weren't even the same within the two regional health authorities.
  • Robinson said Friday that policies have been established and changes made that are addressing cleanliness concerns. "And they have improved on their targets of cleaning in the hospital sector," she said. The union claims its research into the three companies they believe are being considered to take over those services - Sodexo, Aramark and Compass - shows a poor track record. The union said it's also concerned about the quality of food declining. The union wants to keep the management of hospital environmental services in-house. Calls made to Sodexo, Aramark and Compass were not returned by press time.
Govind Rao

Hospital food services will be privatized by fall - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nbml|20150703|224075000

from heather NB hospital food privatization

shared by Govind Rao on 06 Jul 15 - No Cached
  • Miramichi Leader Fri Jul 3 2015
  • The Liberal government plans to have a deal by fall to see a private firm take over the management of food and cleaning services in the province's hospitals. The Liberals have signalled that they want to give the private sector a greater role in the province's health-care system. Health Minister Victor Boudreau announced in April that government had started negotiating with a private firm to deliver some services in both health authorities.
  • That direction was reinforced by Horizon Health Network CEO John McGarry earlier this week, who has now suggested the use of private health-care firms could pull physiotherapists, audiologists, dietitians and other outpatient services from hospitals. The government confirmed on Tuesday that it soon expects to ink a deal with a private provider. "We are still in current discussions with the preferred proponent and we hope to have completed the process sometime this fall," said Health spokesman Bruce Macfarlane in an email.
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  • Macfarlane stressed that the contract is "only outsourcing the management of the services." "CUPE staff will remain in their union and will continue to be employees of the province of New Brunswick," he added. Boudreau has said that the move will save the province millions of dollars through efficiencies brought in by a private company. The government maintains that change is needed.
  • "New Brunswickers have been very clear - change is necessary and government needs to get its fiscal house in order," Macfarlane said. "We can no longer continue with the status quo. "We are undergoing a strategic program review to look for efficiencies and to uncover programs or services that could be changed or discontinued as well as find sources for revenue." McGarry said in a speech to the Rotary Club of Saint John in the Port City on Monday that a needed ideological shift in health care should see even greater use of private health-care firms.
  • "I think there are opportunities for the private sector to get more involved in our system in the things that we don't do as well as we should," he said. "Publicly paid, but privately delivered, contracted. "Do some of the services we provide under a public system really belong in the public system?" McGarry specifically cited outpatient services.
  • "If you look at hospitals these days, you find so many ambulatory care services that are in the hospital system," he said. "Sometimes there is a private provider out in the community. "We have physio, there is private physio. We have audiologists, there are private audiologists. We have dietitians, there are private dietitians. You start to say, 'How did we ever get into this?' "As we start to shrink our infrastructure, these are the things that pop out." McGarry said the health authority is now at the beginning of five-year plan to redirect $48 million currently being spent on hospital infrastructure.
  • Meanwhile, the government has declined to reveal the prospective proponent of the food and cleaning services contract until a deal is finalized. But CUPE spokeswoman Norma Robinson says the Department of Health has informed the union that food and facilities management giants Sodexo, Aramark and Compass Group are involved in the bidding process. She said the union was told that the government is seeking a 10-year contract, first negotiating with Sodexo, to hammer down a deal within the next three to six months.
  • Sodexo has previously confirmed its interest in the contract to the Telegraph-Journal. Robinson said on Tuesday that questions remain as to what the impact of any deal will be on current public sector workers. "We don't know what this contract is going to look like from the union perspective," she said. "They are saying it's just the management today, but what does that look like when Sodexo gets in here? "What does that look like for the employees of the system?"
Govind Rao

Medicare's safety valves - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150323|216966837

from heather medicare private clinics privatization

shared by Govind Rao on 23 Mar 15 - No Cached
  • National Post Mon Mar 23 2015
  • When government monopolies fail to provide the level of service citizens expect, or when excessive regulations on an industry limits competition and drives up prices, people often seek a market-oriented solution that will provide the services they want at a price they are willing to pay. Uber offers a great example of how people are using technology to bypass the government's taxi oligopoly in many major cities. Although there is not yet an app that would allow Canadians to get a colonoscopy from a private practitioner, people in this country have, for decades, travelled abroad to bypass the long wait times that are endemic to the Canadian health-care system.
  • How many people are seeking medical treatment abroad? A new Fraser Institute study surveyed Canadian physicians to find out how many of their patients went out of country in search of timely care. It estimates that 52,513 people received medical care abroad in 2014, although the authors note that this estimate does not take into account those who left the country without first consulting their doctor here at home. And the number of Canadian medical tourists is growing, having risen from 41,838 in 2013. The reason may not be hard to find. A study released last year by the U.S.-based Commonwealth Fund ranked the health-care systems of 11 industrialized countries and placed Canada second to last overall. Interestingly, two countries that have similar systems to ours, the U.K. and Australia, ranked first and fourth respectively.
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  • he main difference is that although these countries have universally accessible health-care systems, they also allow people to receive private medical services by paying outof-pocket or purchasing insurance. Their systems result in better overall care, for two main reasons. First, competition from private hospitals and medical practices provides an incentive for the public system to improve. As the C.D. Howe Institute's Åke Blomqvist and Colin Busby argue in a policy paper released last month, in Canada, "lack of competition between provincial health insurance plans and privately financed medicine has lessened the pressure on publicsector managers and politicians to improve an inadequately performing system."
  • Having a parallel private alternative also helps reduce wait times in the public system. Last year, Canadians waited an average of 9.8 weeks to receive medically necessary treatments after seeing a specialist - three weeks longer than what most doctors consider to be "reasonable." In the Commonwealth Fund study, Canada ranked dead last in terms of "timeliness of care," while the U.K. came in third and Australia sixth. (The U.K. and Australia also ranked first and second respectively in terms of quality of care.) Fears of a mass migration of doctors into the private system are easily answered. In the U.K., doctors trained in public universities are required to work in the National Health Service (the public system) for at least two years before they can move into the private system. Doctors who receive NHS funding are also allowed to set up parallel private practices, but must work 40 hours a week for the NHS.
  • Fortunately, Canadian provinces have quite a bit of leeway to experiment with allowing more privately delivered medical services. As Mssrs. Blomqvist and Busby argue, "Although this is not widely understood, the [Canada Health Act] does not rule out transactions in which providers are paid privately for their services. There is also no prohibition on private insurance that covers the same services as those under the public plans, provided these services are supplied entirely independent of publicly funded services." Indeed, all that is needed is for provincial governments to take the initiative and remove some of their restrictions on private health services.
  • The health-care debate in this country has traditionally focused on comparing our system with that of the United States. Yet the truth is that we have much more in common with European and other industrialized countries. As many of these countries have shown us, it is possible to provide world-class health care that is accessible to all people, while allowing those who choose to pay for private services to do so here at home, rather than travelling overseas.
Irene Jansen

Medecins Québécois pour un Regime Public. Two-Tier Radiology: Quebec's Creep... - 2 views

www.mqrp.qc.ca

doctors quebec coalition ally private clinics

shared by Irene Jansen on 19 Nov 12 - No Cached
  • Irene Jansen on 19 Nov 12
     
    Our 2012 annual report is now available in English The report shows: "While it has more material and human resources, Quebec is less effective than Canada as a whole in providing accessible medical imaging services. The exclusion from public coverage of CAT scan, MRI and ultrasound tests performed outside a hospital leads to joint public-private practice that has the effect of draining resources from the public to the private sector. This damaging distortion leads to problems of access to medical imaging for most patients…"  The report documents the inequitable, inefficient, costly and potentially unsafe utilization of medical imaging technology in Quebec's unique and highly privatized system.  One aspect, the relatively effective use of technology in hospitals compared to private clinics (which would be better yet if the system were entirely public), is clearly not limited to Quebec: "According to a 2008 study by Bercovici and Bell of public hospitals and private clinics offering MRIs in several provinces, including Quebec, the rate of use of machines is about 50% higher in hospitals than in private clinics: an average of 14.7 hours of operation per day during the week and 11.8 hours per day on weekends for hospital machines, compared to 9.7 hours per day during the week and 8.2 hours per day on weekends for machines in clinics." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645224/ The recommendations are also valuable information. 
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