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Govind Rao

Manage dementia while there's still time; A 'tidal wave' of dementia is coming our way,... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|tost|20150325|217119724

from heather dementia seniors ltc continuing care

shared by Govind Rao on 25 Mar 15 - No Cached
  • Toronto Star Wed Mar 25 2015
  • A 'tidal wave' of dementia is coming our way, March 22 The high incidence and rapid increase of Alzheimer's and other aging brain diseases should spur Health Canada and provincial governments to work together effectively and efficiently to manage this inevitable tidal wave, while there still exists a window of opportunity. It is key to remember that when Canadian medicare was planned and instituted decades ago, it was primarily focused on diseases of a Canadian population that was younger and in need of "acute care" medical services. With the greying of the population over time, in addition to increases in life expectancy, health-care needs are rapidly shifting toward chronic care.
  • Our health-care system has not been successful in keeping pace with dementia, Alzheimer's and other brain-related conditions and diseases that call for greater attention and resources to be allocated to chronic care. The effective management of this issue will not only enhance patient and caregiver satisfaction but also will have a serious impact on future medicare costs in Canada and other developed countries. Dr. Margaret Chan, director-general of the WHO, raises an important issue when she bemoans that the world is not prepared for this looming catastrophe. Canada is globally recognized as one of the leaders in health care and we must seize this opportunity to do what is right, right now. Rudy Fernandes, Mississauga
Govind Rao

Pharmacare is the wrong solution at the wrong time - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150325|217107959

from heather pharmacare

shared by Govind Rao on 25 Mar 15 - No Cached
  • National Post Wed Mar 25 2015
  • Earlier this month, to great fanfare and much media attention across the country, the Canadian Medical Association Journal announced the publication of a new study trumpeting the great benefits Canada would accrue by going ahead with national, government-funded pharmaceutical drug coverage. Dubbed "Pharmacare" by its proponents, the study's authors claimed such a plan would save Canadians approximately $7 billion per year in drug costs, with little to no tax increases, and would greatly improve the health of Canadians by providing drugs to the 10% of us who currently cannot afford to pay for prescribed medications.
  • On the surface of it, such claims sound like a win-win situation - more coverage for less money, with better health outcomes. But on closer inspection, the CMAJ study makes some highly dangerous assumptions, and ignores the potential of Pharmacare to expose Canadians to a financial sinkhole that could further push our already strained health-care system towards collapse. The study's authors falsely claim that Canada is the only industrialized country with a universal health-care system that does not provide national drug coverage to its citizens. However, in actuality, Canada is the only country in the industrialized world with universal health care that does not have a second, private tier of health care, and one of only three nations in the industrialized world that does not require its citizens to pay some form of user fee for medical services.
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  • The countries cited in the CMAJ article as examples Canada should copy all have extensive private health-care systems, and all achieve significantly better health outcomes than do we, usually at a lower cost. This is significant in that public drug coverage is affordable to the governments in many of these countries due to the savings achieved by shifting part of the burden of paying for health care to the private sector. So, unless the CMAJ authors are interested in discussing Pharmacare within the setting of a fundamental rethink of our health-care system, including private care and user fees, the entire premise of their argument - comparing us to our international peers - is misleading and inappropriate.
  • So, when our national healthcare system is broke and underperforming, and when even the CMAJ authors admit in their own overly optimistic "worst-case" scenario that Pharmacare might require $5 billion in additional funding off the bat - money our governments simply do not have - now is not the time to introduce an untested new national program of unpredictable cost. As a famous Irish proverb once said, "It's no use carrying an umbrella if your shoes are leaking." A good umbrella Pharmacare may be, but when it comes to health care in Canada, we should have only one priority - fixing the leaks in the shoes we already own. Dr. Brett Belchetz is an emergency room physician and a senior fellow with The Fraser Institute.
Govind Rao

Health care system has been under attack - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|crcn|20150325|217118231

from heather cupe hospital bc accord campaign

shared by Govind Rao on 25 Mar 15 - No Cached
  • Campbell River Courier-Islander Wed Mar 25 2015
  • It's time for Canadians to take back the public health care agenda. For far too long, forces have been chipping away at our most cherished social program. To get a glimpse of the future facing public health care today, just follow the money. This March 31 marks the first anniversary of a decade-long $36 billion cut to health care transfers to the provinces by Ottawa. B.C.'s share of that historic 10-year long reduction totals $5 billion.
  • I think we can all agree that less money for health care is not what is needed for our province. In fact, a Conference Board of Canada report released last August determined Victoria must invest $1.8 billion more than budgeted for health care between 2014 and 2017 just to maintain current service levels. With an aging population requiring more complex care, this deliberate underfunding of services by both federal and provincial governments is playing out in very ugly ways - and the signs are everywhere. Take the growth in private health care. For a third-year in a row, B.C. was fined for allowing illegal extra-billing of patients for services that are supposed to be without cost to all Canadians under the Canada Health Act. Later this June, a B.C.-based private hospital owner will push for the reintroduction of two-tier medicine into Canada at the province's Supreme Court. Then there's the impact on seniors' care. According to a poll conducted last September, many of B.C.'s frail elderly do not receive the attention they require.
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  • Approximately three-quarters of B.C. care aides surveyed said they are forced to rush through basic care for the elderly and disabled because of high workloads and reduced staffing. And let's not forget the workers who bear the brunt of health care cuts. Between January 21 and February 26, nearly 1,500 health care workers were laid-off at care homes and hospitals across B.C. because of contracting out or contract flips. Any former workers rehired at these facilities can expect to start at the bottom of the employment ladder. Some will lose their pension, others will receive lower probationary wages and most will have zero-earned vacation time. It's plain to see public health care is going down a bad road.
  • As we head towards a federal election, Canadians have an opportunity to think about how they can best vote for health care in 2015. The next government in Ottawa can take immediate steps to put our nation's signature social program back on the right track. That means your vote - and the vote of your family and friends - can make a difference in electing MPs that will fight for health care. They say voters get the government they deserve. And we certainly are due for leadership in Ottawa that puts the future of a strong public health care system front and centre in their election promises. To learn more about what can be done to save public health care, please visit saveourhealthcarebc.ca online. Bonnie Pearson, HEU Secretary-Business Manager
Govind Rao

Ambulance fees unfair, dangerous obstacle to care - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|tost|20150327|217276859

from heather ems user fees Ontario ally

shared by Govind Rao on 27 Mar 15 - No Cached
  • Toronto Star Fri Mar 27 2015
  • Imagine you're a physician seeing a 6-month-old child in clinic. She has a fever and cough, she's working hard to breathe and her oxygen levels are falling. You know she needs assessment in the emergency room and requires transportation in an ambulance in case her condition worsens en route. Her family understands the urgency of the situation, but asks, "Could we take her there in our car?" Experiencing a medical emergency is an incredibly stressful experience for patients and their families. This stress should not be compounded by worries about getting an ambulance bill they can't afford. As physicians, we know the importance of the first few minutes of an emergency situation, and the crucial role of Emergency Medical Services (EMS) in saving lives. And yet ambulance fees remain a significant barrier to people receiving necessary care across Canada.
  • One young mother recently spoke to the Saskatchewan press about receiving a bill of $7,000 after several ambulance trips were required for her severely ill daughter. Connie Newman of the Manitoba Association of Seniors Centres recently described to reporters the plight of an elderly woman who walked to the hospital in -40 C because she could not afford an ambulance. How often are people forced to choose the unsafe option of driving themselves or their loved ones to hospital simply because they cannot afford to pay? A recent CBC Marketplace survey revealed that 19 per cent of Canadians did not call an ambulance due to cost. Clearly, this is an issue that our provincial and territorial health ministers need to address. A look across our provinces and territories reveals a patchwork system for financing ambulance services. New Brunswick has recently removed ambulance fees for anyone who does not have private insurance coverage. All other provinces and territories in Canada - with the exception of the Yukon - charge ambulance fees. The burden of cost to patients is highest in the prairies: Manitoba charges up to $530 per trip, and Saskatchewan tacks on fees for interhospital transfers on top of the $245-$325 fee for an ambulance pickup from home.
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  • In Ontario, the cost is typically much lower at $45 per trip, but increases to $240 if the receiving physician deems it unnecessary. The reality on the ground violates the spirit, if not the letter, of the Canada Health Act: Equal access to physician and hospital services means little if safe passage to them is anything but. There are a variety of options to reduce this inequity in access. One option is to follow New Brunswick's lead and offer full coverage. An alternative would be to only charge users if the ambulance ride is deemed medically unnecessary. However, differentiating "appropriate" from "inappropriate" ambulance use isn't straightforward, and can vary between providers. What's more, evidence suggests that institutions - schools, long-term care facilities, hospitals and police services - more often initiate potentially unnecessary ambulance services than do individuals, as a result of compliance with internal policy or protocol.
  • As with other areas of health care, user fees are a blunt tool: they reduce both necessary and unnecessary use of services. The risk of footing the bill could deter people, especially those living in poverty, from calling for help. This would deny them not only safe transport to hospital, but also the initial emergency interventions by paramedics that can mean the difference between life and death. Public education and enhanced availability of primary care are more effective ways to decrease unnecessary ambulance use. Ideally, ambulance services should be fully covered for everyone. This would, however, require provincial governments to take on more of the costs. In Nova Scotia, that cost is an estimated $9.7 million, according to the Nova Scotia Citizen's Health Care Network. This is a drop in the bucket of the $6.2-billion Nova Scotia health-care budget; a small investment to ensure everyone, regardless of income, has access to vital emergency care. The variety and inequity of ambulance charges in Canada is a policy mess. Canada's health ministers should work together to establish a consistent and compassionate approach that balances cost with the need to remove barriers to care. Ryan Meili is an expert adviser
  • with EvidenceNetwork.ca, a family physician in Saskatoon and founder of Upstream: Institute for a Healthy Society. @ryanmeili Carolyn Nowry is a family physician in Calgary. They are both board members with Canadian Doctors for Medicare.
Govind Rao

Profit is all in long-term care - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=ar|7050988|edjn|20150401|217596281

from heather ltc profit Alberta

shared by Govind Rao on 01 Apr 15 - No Cached
  • Edmonton Journal Wed Apr 1 2015
  • Re: Care home criticized for moving senior, March 25 The brief mention of the eviction of my handicapped sister, Rebecca Ali, and the banning of another sister, Julie, at the Good Samaritan Millwoods Care Centre on Feb. 19, skims over some troubling issues in monitoring and legislative gaps in the long-term care (LTC) system. Complaints can lead to reprisal without recourse, as in our case. What we found out is that LTC facilities set their own admission conditions. They can evict or involuntarily transfer without notice, increase rent overnight and ban without reason or recourse. The most vulnerable in our society lack the same housing protections found in our Residential Tenancy Act.
Govind Rao

The Largest Unpaid Healthcare Workforce You've Never Heard Of Is Going Digital - Forbes - 0 views

www.forbes.com/...ever-heard-of-is-going-digital

from heather caregivers us seniors home care continuing care

shared by Govind Rao on 27 Oct 15 - No Cached
  • What struck me was just how much both technology and informal caregiving are a part of daily life for this group, and yet we don’t naturally connect the two. Instead, we make the false assumptions that the elderly are tech-averse and all healthcare in this country is administered by paid professionals.
  • So just how many caregivers are there? With some estimates as high as 66 million, informal caregivers may be the largest healthcare work force you’ve never heard of.
  • invisible female family members
  • ...4 more annotations...
  • undervalued and sometimes unpaid work equates to a second job for these women
  • for over 20 hours per week on average. And to be clear, most are doing more than just cooking for mom – they are changing dressings, reading vitals and administering medication.
  • According to the AARP 2013 seminal work on “Valuing the Invisible” about 40 million family caregivers in the U.S. provided an estimated 37 billion hours of care to an adult with limitations in daily activities.
  • Another study, by the Rand Corporation in 2015, valued those unpaid caregiving services at $522 billion annually. Caregivers represent the “safe discharge option” for our massive healthcare system. Without this unheralded workforce, it is safe to suggest that the U.S. would be spending significantly more than $3 trillion annually on healthcare.
Govind Rao

Health-care system in need of more transparency, report says | Toronto Star - 0 views

www.thestar.com/...d-in-health-system-report.html

from heather quality privatization

shared by Govind Rao on 16 Nov 15 - No Cached
  • C.D. Howe Institute says there should be more public reporting on patient experience within Canada’s health-care system.
  • Seniors health was a hot issue during the recent federal election. A recent C.D. Howe Institute report argues Canada's whole health care system needs greater transparency.
  • By: Theresa Boyle Health, Published on Thu Nov 12 2015
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  • Canada’s health system is not transparent enough, says a new report that calls for more public reporting on patient experience, such as in instances when they are harmed. Consideration should be given to publicly reporting physician-level outcomes, such as death rates for patients of individual cardiac surgeons, states the report published Thursday by the C.D. Howe Institute. More collection and public disclosure are critical to creating better value for the health system, it says, urging the federal and provincial governments to pave the way. “From a democratic perspective, publicizing outcome measures can empower patients, families and communities to engage in the policy debate about which outcomes matter most and at what cost — and in the ways health care should be delivered,” says the report, titled “Canadian Health Care Needs a Checkup, Here’s How.”
  • Health-care outcomes that could be measured and publicly reported include data about death, disease, disability, discomfort and dissatisfaction, it states. As well, there could be more transparency surrounding patient satisfaction and health-system responsiveness.
  • “Public reporting of any individual physician or health-care provider has not shown to improve patient outcomes or satisfaction levels,” a statement from the OMA said. “Our health-care system is made better through the collection and reporting of accurate and meaningful data that physicians use to innovate how they deliver care.”
Govind Rao

Frailty, thy name is Palliative! - 0 views

www.cmaj.ca/...1312.2

from heather palliative seniors ltc

shared by Govind Rao on 16 Nov 15 - No Cached
  • CMAJ November 17, 2015 vol. 187 no. 17 doi: 10.1503/cmaj.1150074 Letters
  • Vincent Maida, MD MSc BSc FCFP, Melissa Devlin, MSW RSW
  • Frailty remains a vague and subjective construct that represents an amalgam of curable and incurable illnesses. Furthermore, increasing levels of frailty combined with advancing age translates into decreased life expectancy. A common attitude within health care is that frailty is generally reversible and curable. Thus, is the word “frailty” being used as a euphemism? Are the patients in this study simply frail or are they terminally ill? The documentation of frailty, or worsening of frailty scores, should trigger the need for patient-centred discussions about diagnosis, natural history of disease, prognosis, treatment options and goals of care.2 This process may trigger the need for a palliative care consultation.
Govind Rao

Share of health spending on doctors increases - 0 views

www.cmaj.ca/...E506

from heather doctors wages chc

shared by Govind Rao on 22 Dec 15 - No Cached
  • CMAJ December 8, 2015 vol. 187 no. 18 First published November 9, 2015, doi: 10.1503/cmaj.109-5191
  • Carolyn Brown
  • After years of erosion, doctors’ share of health spending has rebounded to levels last seen in the 1980s, according to the Canadian Institute for Health Information’s (CIHI’s) annual release of national health expenditure data. But it comes from a pie that is slowly shrinking, as health spending has not kept pace with inflation and population growth.
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  • Figures compiled in CIHI’s database over 40 years show the share spent on physicians hit an all-time high in 1988, then slowly declined until 2007, when it turned around, growing at about 2.2% annually. It now accounts for 15.5%, comparable to levels seen in the late 1980s. Hospital spending has decreased from 45% of total health spending in the mid-1970s to just under 30% today, whereas drug spending has been increasing since the mid-1980s to account for just under 16% of spending.
  • “The guild has done a great job of protecting our income,” Dr. David Naylor said, referring to medical associations’ success in negotiations with governments. “But wouldn’t you expect [the share of spending on physicians] to drop a little?” Naylor, past president of the University of Toronto and chair of the Advisory Panel on Healthcare Innovation, spoke at a panel discussion on the CIHI findings, held Oct. 29 in Ottawa.
  • He said the “constancy of focus on doctors, drugs and hospitals … speaks to the stasis in the system. If anything, it’s in a state of arrested development.” While overall health spending has gone up in dollar terms, amounting to $6105 per capita in 2015, it has declined as a proportion of gross domestic product (GDP). After the 2008–2009 recession, health spending fell from 11.6% of to an estimated 10.9% of GDP today. When inflation and population growth are taken into account, health spending also shows a decline.
  • The first half of this movie seems similar to what happened in the 1990s,” said Don Drummond, an economist at Queen’s University. He said that in the 1990s, government austerity led to a decline in health spending, but a return to a good economy resulted in health spending growing “much faster than economic growth.”
  • In regard to the similar spending decline after 2011, Drummond asked “did we create efficiencies or just cut off the money and create pressure?” Drummond and Naylor clearly think that efficiencies are lacking. The solution, said Naylor, is integrating services, including home care and virtual care. “There’s not a single province that has taken steps in that direction.”
  • CMA President Cindy Forbes agreed. “We need integrated, appropriate and high-quality care.” She gave the example of a patient in an acute care hospital discharged to community care and later moving to palliative care. “The patient goes through three different systems. They all have their own budgets and caregivers. These silos have to be broken down so it’s one system.”
  • She stressed the need for a national seniors’ strategy to address a population that is aging and living longer, often with complex, multiple diseases. Integrated services could address the patients needing an alternative level of care who currently occupy 20% of beds in acute care hospitals, she said. “They are not ‘bed blockers,’” she said. “They are waiting for long-term or home care.”
  • Naylor also thinks changing the way physicians are paid is part of the solution. “The fee schedule is full of perverse incentives. It doesn’t create ‘integrative quarterbacks.’ There should be rewards for good prescribing and shorter hospital stays.”
  • Wide variations in the price tag for health care among provinces and territories also stood out in the data. Costs in Canada’s provinces range from $5665 per person per year in Quebec to $7036 in Newfoundland and Labrador. (In the territories, costs are much higher.) Seven provinces devote more than 40% of their budget to health, of which two devote more than 45%.
  • Demographics and geography account for some of the variation, according to Brent Diverty, CIHI’s vice-president of programs, especially costs to transport critical cases from remote areas. However, panellists expressed concern about inequalities in quality of care and access.
  • “People who are covered for a drug in one province are not covered in another,” pointed out Forbes. “Especially cancer drugs, which are expensive.”
  • Naylor added, “There’s a huge challenge for the [federal/provincial/territorial ministers] to understand this variation. We need to unbundle why these disparities occur. How do we get to a common higher ground as Canadians?”
Govind Rao

Health care: Mr. Trudeau, time to put words into action | Canadian Union of Public Empl... - 1 views

cupe.ca/-trudeau-time-put-words-action

from heather federal accord cupe

shared by Govind Rao on 19 Jan 16 - No Cached
  • Jan 18, 2016
  • Canada’s health ministers are meeting this week, January 20 – 21, in Vancouver.
  • During the federal election Liberals promised to negotiate a new Health Accord with the provinces, and committed to provide $3 billion over four years for improvements in home care.
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  • CUPE is calling for: a new Health Accord with increased funding – at a minimum of six per cent increase per year, as with the 2004-2014 Accord. more resources for seniors’ care, especially long-term care and home care. a universal Pharmacare program.
Govind Rao

Some hope, many concerns following health ministers meeting | Canadian Union of Public ... - 1 views

cupe.ca/owing-health-ministers-meeting

from heather coalition cupe accord

shared by Govind Rao on 28 Jan 16 - No Cached
  • Jan 27, 2016
  • Canadian health ministers met last week to discuss the future of our health care system. While we express optimism a new Health Accord will be reached by federal and provincial governments, it is certainly cautious optimism.
  • Funding: No new money, and no new Health Accord… yet
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  • Seniors: no new strategy
  • Drugs: bulk-buying proposal may be counterproductive
  • Bulk-buying is one part of the solution but in and of itself it is not a national Pharmacare plan.
  • CUPE will continue to pressure all levels of government to commit to a new health accord. On January 26, many CUPE members joined 130 activists from the Canadian Health Coalition in a lobby of 140 Members of Parliament, in Ottawa.
Mike Old

HEU rallies against privatizing IHA laundry service - 0 views

cfjctoday.com/...ivatizing-iha-laundry-services

privatization cupe hospital laundry

shared by Mike Old on 01 Mar 16 - No Cached
  • Mike Old on 01 Mar 16
     
    KAMLOOPS - Members of the Hospital Employees Union rallied outside a seniors care home in Kamloops this afternoon. Several dozen HEU members gathered on the lawn outside of Ponderosa Lodge, as the decision to privatize laundry services across the Interior Health Authority looms. If IHA decides to contract out, 175 jobs at 11 facilities throughout the Interior, would be eliminated.
Govind Rao

New debate needed on Canada-EU trade deal | - 0 views

www.hilltimes.com/...53463

from heather trade international

shared by Govind Rao on 10 Mar 16 - No Cached
  • It is time for Canada to lead in re-evaluating what type of trade agreements are needed for this century.
  • By HOWARD MANN PUBLISHED : Wednesday, March 9, 2016
  • While the Comprehensive Economic and Trade Agreement (CETA) text was in long-term legal scrub, it had taken a back seat to discussions over the Trans-Pacific Partnership Agreement (TPP) concluded by the Conservative government during the last election campaign. The TPP has attracted vocal opposition from very diverse sources in Canada, including major innovators, labour unions and organizations focused on achieving sustainable development. With the release now of the final CETA text—the trade agreement between Canada and the EU—new debate is needed on it as well.
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  • Included in the statement released by Canada and the EU to mark the end of the legal review was the announcement that the investor-state arbitration model long entrenched in Canada’s international agreements has been replaced by a system that more closely resembles an international court. The new court-like system includes independent judges, an appeals process and, generally, more transparency and predictability. There can be little doubt that this is a significant improvement over the previous arbitration process.
  • Trade Minister Chrystia Freeland, after referring to CETA as a gold-plated trade agreement, stated that with these changes, “Our dispute resolution process is brought up in this agreement to the 21st century democratic standards that Canadians demand.” This view begs two questions. First, why have a new international court that can override domestic courts that already meet the democratic expectations of Canadians? Second, does the rest of the agreement also reflect 21st century democratic needs and standards?
  • The investment chapter and its international court will still give foreign investors special rights and remedies to challenge government actions that they see as unfavourable to them. This gives one economic stakeholder a significant legal advantage over all other actors and stakeholders in the economy. It will allow this one class of economic actor to circumvent domestic courts by going directly to an international court whose role is to apply international law to protect their investor rights.
  • The justification for this is that these mechanisms will attract new investors to new places. However, this fails to stand up to empirical evidence developed over the past 10 to 15 years that shows these types of special rights for investors have no impact on investment flows. In short, there is no payoff for governments that put their countries at risk of exposure to international dispute settlement processes that circumvent domestic courts.
  • So do the other provisions of CETA reflect 21st century goals and standards? In both the TPP and CETA, it is the chapters that don’t directly relate to trade that make the agreements ‘comprehensive.’ It is these rules that are becoming increasingly broad and ever more favourable to large economic actors.
  • Let’s take the Intellectual Property Rights (IPR) rules, for example, which go farther to favour European drug manufacturers over Canadian manufacturers, and Canada’s health care system, than any previous IPR agreement. There is also the chapter on “Domestic Regulation” that goes farther in limiting government rights to review and regulate new investments in every sector of the economy than any previous treaty has gone. The CETA also features a long list of limitations on government’s ability to maximize the value that Canadians derive from foreign investment, including such future projects as Ontario’s ring of fire for mining.
  • These non-trade chapters will contribute to the ongoing growth of legal and economic inequality of average citizens and small and medium-size businesses compared to the large economic actors. These chapters simply replicate and deepen provisions from 10, 15 and 20 years ago, or more, with no new assessment of their impacts in today’s world, on climate change responses, or on the needs of sustainable development.
  • The UN Sustainable Development Goals adopted in 2015 provide a framework to realign the goals of trade and economic agreements for the future rather than just replicate the measures of the past, measures that continue to work against sustainable development needs. With the growing concerns over TPP, the inconsistent approaches between TPP and CETA on key democratic principles, and the obvious need to prioritize climate responses over trade policy, it is time for Canada to lead in re-evaluating what type of trade agreements are needed for this century.
  • Canada now has a unique opportunity to step back, reflect, and then return to lead global trade-law into a sustainable development era.
  • Howard Mann is the senior international law adviser with the International Institute for Sustainable Development.
Govind Rao

Little change in wait times, reports find; New studies highlight Saskatchewan as an exa... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20151208|235370951

from heather waits Saskatchewan privatization lean accord

shared by Govind Rao on 08 Dec 15 - No Cached
  • The Globe and Mail Tue Dec 8 2015
  • Canadians continue to queue up for medical care with efforts to reduce wait times bringing limited improvements, say two new studies that come one month before federal and provincial ministers meet to begin negotiating a new health accord.
  • The pair of annual reports - one from the Wait Time Alliance, the other from the Fraser Institute - find little year-over-year change in the wait for medically necessary procedures. Where there is improvement, the report from the Wait Time Alliance finds the progress is "spotty" with access to care, dependent on where in the country you live and, at times, your age.
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  • The Alliance, a coalition of medical specialists, is calling on provincial and federal leaders to help fashion a "new national vision for health care," one that sets national benchmarks that go beyond the 2004 initiative that targeted five procedures: hip and knee replacements, cataract surgery, heart operations, diagnostic imaging and cancer radiotherapy.
  • We still don't measure nearly enough," said Dr. Chris Simpson, chair of the alliance and a former president of the Canadian Medical Association. "You can't fix what you can't measure."
  • At a time when more care is moving out of the hospital, Dr. Simpson said wait times for home care and long-term care beds should be monitored by all provinces, as should the number of patients in hospital because they cannot access these services.
  • When health ministers meet in January in Vancouver, Dr. Simpson said he hopes a partnership to establish such standards will be part of the discussion, rather than just the level of federal funding. "If we have made a collective mistake in the past, it is to say to the federal government, 'It's all up to you,' " he said.
  • The annual report card provides a snapshot of wait times across a range of measures gathered from provincially available information this summer. In doing so, it highlights the variation in the information available among provinces, and this year also notes that the federal government - responsible for delivering health care to First Nations, refugees, veterans, Canadian Forces and inmates in federal prisons - provides only limited data on its own performance.
  • The study, which gives a grade to provinces across a range of procedures, finds those provinces that got high marks last year - Saskatchewan, Ontario and Newfoundland and Labrador - continue to do well.
  • Both studies point to the success of Saskatchewan in cutting wait times as evidence of what can be done with a focused effort and both note that the improvement came from more than increased funding.
  • In five years, the number of patients in Saskatchewan waiting more than six months for surgery dropped by 96 per cent, the Alliance report card finds, thanks to a $176-million investment over four years and also because of innovative practices. Bacchus Barua, a senior economist at the Fraser Institute and author of its wait-time study, said measures such as a pooled referral system helped give Saskatchewan the shortest wait times in the survey.
  • The report from the Fraser Institute is based on a survey of specialists and tracks the time between the initial referral and the appointment with a specialist as well as the time between seeing a specialist and treatment. At the national level, it found the median wait time from referral to treatment was 18.3 weeks, almost the same as the 18.2 weeks recorded in 2014, but almost double the 9.3 weeks recorded in 1993 when the survey began.
  • Across Canada, wait times have stabilized, but they have stabilized at a very high level," Mr. Barua said
  • Saskatchewan had the shortest total wait at 13.6 weeks and Prince Edward Island had the longest at 43.1 weeks, although the small sample size in PEI makes that result less reliable. Among specialties, the longest waits were for orthopedic surgery at 35.7 weeks and the shortest were for patients in line for radiation oncology at 4.1 weeks, the study said.
Govind Rao

Health care a key issue in 2016 Saskatchewan provincial election | Regina Leader-Post - 0 views

leaderpost.com/...skatchewan-provincial-election

from heather Saskatchewan lean cuts election

shared by Govind Rao on 15 Dec 15 - No Cached
  • December 14, 2015
  • December 14, 2015
  • The Saskatchewan Party has been on a roller coaster ride of late on the one issue that makes all governments facing an election nervous — health care.
  • ...4 more annotations...
  • ows, such as looming job losses in the Saskatoon Health Region as it tackles a projected deficit of almost $50 million.
  • the government has faced complaints about poor care of seniors in the province’s nursing homes and stubbornly long ER wait times.
  • And the $40-million lean management process that is supposed to deliver efficiencies and improve services to patients remains controversial. Critics — including some health care-workers — say the supposed benefits have been overstated by health bureaucrats and politicians and the money would have been better spent on frontline care.
  • $11 million has been spent on the salaries of 120 health workers employed to promote lean, according to the NDP Opposition.
Govind Rao

Court allows Quebec law on assisted dying to go ahead - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20151210|235533245

from heather quebec legislation seniors

shared by Govind Rao on 10 Dec 15 - No Cached
  • The Globe and Mail Thu Dec 10 2015
  • Controversial Quebec legislation on assisted dying will become law on Thursday, says the province's Health Minister. Gaetan Barrette made the announcement Wednesday after Quebec's top tribunal gave the provincial government permission to appeal a lower-court decision that granted an injunction aimed at blocking adoption of the law. "That [Quebec Court of Appeal] ruling means that, as of tomorrow [Thursday], Bill 2 will be implemented fully," he told a news conference. "The ruling does not state anything for or against Bill 2 in any way. What it says is that, as of tomorrow, Bill 2 can be implemented until there is a definitive hearing and definitive decision on the actual grounds of the appeal."
  • Lawyers will be in court for that appeal on Dec. 18. Quebec Justice Minister Stephanie Vallee issued a statement later Wednesday and said the government will send guidelines to the Crown prosecutors' office in Quebec in a bid to reassure people in the medical community who may be worried about criminal proceedings. She said the guideline is aimed at "allowing people at the end of their lives to receive care that respects their dignity and their autonomy." The legislation, which was adopted by the National Assembly in June, 2014, outlines how terminally ill patients can end their lives with medical help.
  • ...1 more annotation...
  • Quebec is the first province to pass such legislation, arguing it is an extension of end-of-life care and thus a health issue, which falls under provincial jurisdiction. The injunction sought by the Quebec-based Coalition of Physicians for Social Justice and Lisa D'Amico, a handicapped woman, was related to a Supreme Court ruling last February that struck down the prohibition on physician-assisted dying.
Govind Rao

Efficient, yes, but where is the heart in home care? - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20151201|234856342

from heather home care employer bankruptcy

shared by Govind Rao on 01 Dec 15 - No Cached
  • The Globe and Mail Tue Dec 1 2015
  • The Victorian Order of Nurses was, for more than a century, the primary provider of home and community-based care in Canada. Now it is teetering on the verge of bankruptcy. Late last week, theVON shut down operations in six provinces - Alberta, Saskatchewan, Manitoba, New Brunswick, Prince Edward Island, and Newfoundland and Labrador - and filed for protection under the Companies' Creditors Arrangement Act.
  • It will continue to operate in Ontario and Nova Scotia - at least for now. The collapse of the iconic organization, founded in 1897 by Lady Aberdeen, was swift and brutal. It also serves as a cautionary tale about Canadians' tortured relationship with medicare, in particular the conflicting desires to cling to our history of charitable provision of care and achieving efficiencies with unforgiving business models.
  • ...6 more annotations...
  • The VON was trapped, and ultimately crushed, by that contradiction. It was not the first - the Canadian Red Cross Society's legendary blood transfusion service flamed out in an even more spectacular fashion with the taintedblood scandal in which 20,000 recipients contracted hepatitis C or HIV - and it will not be the last. Canadian Blood Services has taken over the former Red Cross role.
  • The health-care advocacy group Friends of Medicare said the neardemise of the VON is proof that "experiments in private care must be ceased." But the VON's story is much more complicated than the "public, good; private, bad" and "notfor-profit, good; for-profit, bad" narrative. For a long time, governments funded not-for-profit groups in the health and social services sectors - hospitals, home care, group homes, the Red Cross and so on - in a pretty loosey-goosey fashion. These groups did good, and they were funded relatively well.
  • But as budgets soared, new accountability measures were put into place. In the home-care sector, for example, competitive bidding was introduced. Stodgy old organizations such as the VON were not ready, and did not adapt. Their market share fell from more than 90 per cent to about 20 per cent. On the surface, this is a good thing. Canadians spend $219-billion a year on health care, including about $10-billion on home care, and, as consumers and taxpayers, they deserve to get value for money.
  • While we like to preach the gospel of value-for-money, we don't measure it well - the ultimate irony being that expensive bureaucracies have been built to ensure home-care agencies are lean and mean. The VON had many disadvantages in a competitive market.. place - first and foremost that it never provided just home care to its clients. It delivered hot meals, made friendly visits (especially to veterans), ran adult daycare programs, provided respite care to families, visited new mothers and babies, did flu shots at home and did countless other little things that never had a place in the accounting ledger. Some were covered by government payments, but many were not. The VON supplemented its funds from government contracts with charitable donations. It had more volunteers (9,000) than staff (6,000). The VON also paid its workers a decent, living wage. The work force - mostly nurses and therapists - is unionized, salaried and they have benefits, including a pension plan.
  • In the brave new home-care industry, piecework is the norm, meaning nurses get paid per visit, and few have benefits, pensions or stable employment. It is also in the interest of workers (and employers) to get visits done quickly, and cram as many as possible into a day. While this is a cost-effective business model, anyone with a loved one in home care knows that there is little continuity of care. The relationships that are so important to intimate acts such as health-care delivery to frail seniors living at home are virtually non-existent. When you have a strict business model, when all that matters is the much-vaunted bottom line, none of that gets counted.
  • The real tragedy in the VON's unravelling is not that another home-care business is biting the dust (after all, there are hundreds more out there), but that the "old-fashioned" way of delivering care - taking the time required to talk and listen to patients and treating them as people, not "units of service" for example, not just changing their dressings, but feeding them and filling the fridge - is falling by the wayside. With the VON's collapse, we have a home-care system that may be more efficient - at least in theory - but one that has less heart.
Govind Rao

High-paid health bosses brought about own undoing - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20151129|234724337

from heather employer wages Ontario home care

shared by Govind Rao on 01 Dec 15 - No Cached
  • Toronto Star Sun Nov 29 2015
  • When high-flying politicians or senior executives come crashing down to earth it is often because their outrageous spending habits or sky-high salaries have been exposed to the public. That's what happened, for example, to Bev Oda in 2012 when the federal Conservative cabinet minister resigned her seat in the House of Commons after it was revealed she had ordered a $16 glass of orange juice at a London hotel and made taxpayers foot the bill.
  • As first revealed three weeks ago by Toronto Star reporter Theresa Boyle, Health Minister Eric Hoskins is signalling that Queen's Park will scrap the CCACs and transfer much of their duties to the province's 14 Local Health Integration Networks (LHINs), which oversee regional health planning. Hoskins will unveil the changes in a "discussion document" to be released in the coming weeks. For years, patients have complained that the $2.5-billion-a-year home-care system was a mess, with too much bureaucracy, a drastic shortage of funds for face-to-face care, mismanagement, lack of oversight, uneven treatment and a culture of fear.
  • ...8 more annotations...
  • And that's exactly what is happening now with the pending demise of 14 huge Ontario agencies that oversee the delivery of home care to hundreds of thousands of patients each year and employ tens of thousands of workers. The bosses involved are the chief executive officers of the 14 Community Care Access Centres (CCACs) in Ontario. These government agencies, which have been embroiled in controversy for several years, are responsible for co-ordinating access to home and community care services, such as nursing, physiotherapy and personal support workers.
  • Even more revealing was the fact that while the CCAC bosses were getting massive pay raises, many of the therapists, personal support workers and nurses who actually provide care to patients were earning less than $25,000 a year and hadn't seen a pay raise in years. Other managers in the CCAC system also earn huge salaries. One vice-president of strategy, communications and engagement earned $193,000 in 2014. In the Toronto Central CCAC, there were 45 employees earning more than $100,000 in 2014. In the Ontario Association of CCACs (OACCAC), there were 37 employees earning more than $100,000 with the executive director earning close to $300,000.
  • Politicians and bureaucrats at Queen's Park, however, regularly dismissed the complaints and did little to fix the broken system. Indeed, under former health minister Deb Matthews, the CCAC bosses were never really challenged to improve their operations. Some were openly hostile, arrogant and aggressive, operating with a sense of entitlement that saw them run their agencies as they saw fit. But as happened to Oda, the heady days for the CCAC executives came to a sudden halt when their skyrocketing salaries and stunning pay raises were revealed. In some cases, CCAC bosses were paid raises topping $65,000 a year, with salaries over $300,000. Others saw their pay jump by more than 50 per cent over three years.
  • Worse was the fact that the CCAC executives were also ordering their staff, most of whom cared deeply about and worked hard to deliver good care, to trim patient services such as the number of visits to patients by front-line health workers in order to meet their budgets. Suddenly, politicians at Queen's Park took notice.
  • n early 2014 an all-party legislative committee asked auditor general Bonnie Lysyk to conduct a wide inquiry into CCAC operations. Lysyk's report, released in September, described in detail a bloated CCAC system that costs too much money, does nothing very well and where barely 62 cents of every dollar goes to actual direct patient care. For Hoskins, that was the final straw. Now he is about to unleash the biggest change in health-care delivery in Ontario in a generation. Through it all, the CCAC executives were often their own worst enemies.
  • Instead of explaining why they deserved huge salaries, they became aggressive, hiring expensive lobbyists and public relations experts to promote their agencies, denouncing journalists and critics who raised legitimate concerns about the system, and misleading their own staffers on how their operations were faring or what the future might hold for them. When news first surfaced that Hoskins was planning to dismantle the CCACs, the executives denied any real moves were coming and that their futures were in jeopardy. Some CCAC bosses went so far as to tell their staff that the Star's articles about the pending demise of the CCACs were "inaccurate."
  • In recent days, though, the CCACs have gone silent as they come to grips with the realization that their jobs and agencies are likely doomed. Hoskins is not waiting to start the transformation, but his initial timetable for dismantling the CCACs has proven to be problematic. Hoskins originally wanted the LHINs to start assuming some CCAC roles, such as responsibility for front-line staff, as early as three months from now. But sources say these timelines keep being blown up because the LHINs are not yet ready to take on increased duties.
  • Still, Hoskins is planning to press ahead. He will get more ammunition on Dec. 2 for the home-care transformation when Lysyk releases the second part of her inquiry into CCACs. For patients waiting for needed treatment and who have tangled with the CCAC bureaucracy and bosses in the past, the changes can't come soon enough. Bob Hepburn's column appears Sunday. bhepburn@thestar.ca
Govind Rao

Morale crisis at Alexandria hospital?; Staffturnover is high; union has asked Minister ... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|cosf|20151216|235964782

from heather cupe hospital Ontario campaign survey

shared by Govind Rao on 16 Dec 15 - No Cached
  • Cornwall Standard Freeholder Wed Dec 16 2015
  • What would cause 116 staffmembers to leave an organization in under 10 years? In the case of the Glengarry Memorial Hospital, the Ontario Council of Hospital Unions said it's low morale and it is affecting patient care. The OCHU is concerned the low staffmorale and high staffturnover rates are creating internal turmoil and taking a toll on patient care and wants the Minister of health to do something about it.
  • "The situation at the hospital should not be ignored by Ontario's health minister and we are again urging him to intervene and investigate what's going on at the hospital," said OCHU president Michael Hurley. The OCHU is the hospital division of the Canadian Union of Public Employees, the union at the hospital representing registered practical nurses, clerical, cleaning, dietary and other staff.
  • ...4 more annotations...
  • CUPE has written to, and is publicly calling on, Ontario's health minister to look into why the hospital has lost 116 staffmembers since 2007. "What our members are reporting to us is a work environment very hierarchical," said Hurley. "People are not able to speak of issues freely without repercussions. If they do speak up they suffer consequences." Hurley said the high degree of turnover isn't just with union members. Members of management have been leaving the hospital as well. "The info I have been given is the morale is low," said North Glengarry Mayor Chris MacDonell, so he is aware of the situation. Hurley said the hospital has brought in a company to survey staff, but nothing has changed and morale remains low. "The survey suggested a work environment
  • out of step with a modern healthy work environment," said Hurley. "We asked Dr. (Eric) Hoskins, our health minister, to send in an independent investigator. But there has been no response to the valid concerns that we and others have raised," said Hurley. According to a survey of CUPE members at the hospital, 70 per cent of stafffeel people have left because of management at the hospital, and 50 per cent would leave if given the opportunity. Hurley said he has requested to have a meeting with the whole hospital board, but one hasn't been scheduled yet. "That absence of willingness to dialogue shows the deeper problem," he said. "If their employees have serious issues, you would think they would want to hear about them.
  • "Of greatest concern is the fact 47 per cent of respondents feel that the quality of patient care is not a priority at the hospital," said Hurley. "The minister has an obligation to investigate complaints about a toxic work environment at the Glengarry Memorial Hospital, which we believe affects the quality of patient care. Healthcare workers are under enormous stress. They are working hard to try to deliver high quality patient care. When they speak up to call attention to a situation they believe to be hazardous to patients, the minister should listen carefully. That Dr. Hoskins hasn't acted, is just inexplicable." The minister's office said in an email they were familiar with the hospital's situation and have contacted the Champlain Local Health Integration Network about the matter.
  • "In Ontario, LHINs are responsible for planning, funding and integrating services at the local level," said the email from David Jensen, media relations co-ordinator. "We expect that the LIHN will continue to work with the hospital and its board of directors to continue improving care for their patients. We encourage the Glengarry Memorial Hospital senior leaders to continue to work with their staffand unions towards effective communication and a solution that benefits everyone." A message left for Linda Morrow, CEO of the hospital, was not returned. lois.baker@sunmedia.ca twitter.com/LoisAnnBaker © 2015 Postmedia Network Inc. All rights reserved. Illustration: • Greg Peerenboom, Standard-Freehol / The Glengarry Memorial Hospital is shown in this Dec. 14
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