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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
Irene Jansen

Senate Social Affairs Committee review of the health accord, Evidence, September 29, 2011 - 0 views

www.parl.gc.ca/...49055-e.htm

accord waits senate

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Christine Power, Chair, Board of Directors, Association of Canadian Academic Healthcare Organizations
  • eight policy challenges that can be grouped across the headers of community-based and primary health care, health system capacity building and research and applied health system innovation
  • Given that we are seven plus years into the 2004 health accord, we believe it is time to open a dialogue on what a 2014 health accord might look like. Noting the recent comments by the Prime Minister and Minister of Health, how can we improve accountability in overall system performance in terms of value for money?
  • ...97 more annotations...
  • While the access agenda has been the central focal point of the 2004 health accord, it is time to have the 2014 health accord focus on quality, of which access is one important dimension, with the others being effectiveness, safety, efficiency, appropriateness, provider competence and acceptability.
  • we also propose three specific funds that are strategically focused in areas that can contribute to improved access and wait time
  • Can the 2014 health accord act as a catalyst to ensure appropriate post-hospital supportive and preventive care strategies, facilitate integration of primary health care with the rest of the health care system and enable innovative approaches to health care delivery? Is there an opportunity to move forward with new models of primary health care that focus on personal accountability for health, encouraging citizens to work in partnership with their primary care providers and thereby alleviating some of the stress on emergency departments?
  • one in five hospital beds are being occupied by those who do not require hospital care — these are known as alternative level of care patients, or ALC patients
  • the creation of an issue-specific strategically targeted fund designed to move beyond pilot projects and accelerate the creation of primary health care teams — for example, team-based primary health care funds could be established — and the creation of an infrastructure fund, which we call a community-based health infrastructure fund to assist in the development of post-hospital care capacity, coupled with tax policies designed to defray expenses associated with home care
  • consider establishing a national health innovation fund, of which one of its stated objectives would be to promote the sharing of applied health system innovations across the country with the goal of improving the delivery of quality health services. This concept would be closely aligned with the work of the Canadian Institutes of Health Research in developing a strategy on patient oriented research.
  • focus the discussion on what is needed to ensure that Canada is a high performing system with an unshakable focus on quality
  • of the Wait Time Alliance
  • Dr. Simpson
  • the commitment of governments to improve timely access to care is far from being fulfilled. Canadians are still waiting too long to access necessary medical care.
  • Table 1 of our 2011 report card shows how provinces have performed in addressing wait times in the 10-year plan's five priority areas. Of note is the fact that we found no overall change in letter grades this year over last.
  • We believe that addressing the gap in long-term care is the single more important action that could be taken to improve timely access to specialty care for Canadians.
  • The WTA has developed benchmarks and targets for an additional seven specialties and uses them to grade progress.
  • the lack of attention given to timely access to care beyond the initial five priority areas
  • all indications are that wait times for most specialty areas beyond the five priority areas are well beyond the WTA benchmarks
  • we are somewhat encouraged by the progress towards standardized measuring and public reporting on wait times
  • how the wait times agenda could be supported by a new health accord
  • governments must improve timely access to care beyond the initial five priority areas, as a start, by adopting benchmarks for all areas of specialty care
  • look at the total wait time experience
  • The measurements we use now do not include the time it takes to see a family physician
  • a patient charter with access commitments
  • Efficiency strategies, such as the use of referral guidelines and computerized clinical support systems, can contribute significantly to improving access
  • In Ontario, for example, ALC patients occupy one in six hospital beds
  • Our biggest fear is government complacency in the mistaken belief that wait times in Canada largely have been addressed. It is time for our country to catch up to the other OECD countries with universal, publicly funded health care systems that have much timelier access to medical care than we do.
  • The progress that has been made varies by province and by region within provinces.
  • Dr. Michael Schull, Senior Scientist, Institute for Clinical Evaluative Sciences
  • Many provinces in Canada, and Ontario in particular, have made progress since the 2004 health accord following large investments in health system performance that targeted the following: linking more people with family doctors; organizational changes in primary care, such as the creation of inter-professional teams and important changes to remuneration models for physicians, for example, having a roster of patients; access to select key procedures like total hip replacement and better access to diagnostic tests like computer tomography. As well, we have seen progress in reducing waiting times in emergency departments in some jurisdictions in Canada and improving access to community-based alternatives like home care for seniors in place of long-term care. These have been achieved through new investments such as pay for performance incentives and policy change. They have had some important successes, but the work is incomplete.
  • Examples of the ongoing challenges that we face include substantial proportions of the population who do not have easy access to a family doctor when needed, even if they have a family doctor; little progress on improving rates of eligible patients receiving important preventive care measures such as pap smears and mammograms; continued high utilization of emergency departments and walk-in clinics compared to other countries; long waits, which remain a problem for many types of care. For example, in emergency departments, long waits have been shown to result in poor patient experience and increased risk of adverse outcomes, including deaths.
  • Another example is unclear accountability and antiquated mechanisms to ensure smooth transitions in care between providers and provider organizations. An example of a care transition problem is the frequent lack of adequate follow-up with a family doctor or a specialist after an emergency department visit because of exacerbation of a chronic disease.
  • A similar problem exists following discharge from hospital.
  • Poorly integrated and coordinated care leads to readmission to hospital
  • This happens despite having tools to predict which patients are at higher risk and could benefit from more intensive follow-up.
  • Perverse incentives and disincentives exist, such as no adjustment in primary care remuneration to care for the sickest patients, thereby disincenting doctors to roster patients with chronic illnesses.
  • Critical reforms needed to achieve health system integration include governance, information enablers and incentives.
  • we need an engaged federal government investing in the development and implementation of a national health system integration agenda
  • complete absence of any mention of Canada as a place where innovative health system reform was happening
  • Dr. Brian Postl, Dean of Medicine, University of Manitoba, as an individual
  • the five key areas of interest were hips and knees, radiology, cancer care, cataracts and cardiac
  • no one is quite sure where those five areas came from
  • There was no scientific base or evidence to support any of the benchmarks that were put in place.
  • I think there is much less than meets the eye when we talk about what appropriate benchmarks are.
  • The one issue that was added was hip fractures in the process, not just hip and knee replacement.
  • in some areas, when wait-lists were centralized and grasped systematically, the list was reduced by 30 per cent by the act of going through it with any rigour
  • When we started, wait-lists were used by most physicians as evidence that they were best of breed
  • That continues, not in all areas, but in many areas, to be a key issue.
  • The capacity of physicians to give up waiting lists into more of a pool was difficult because they saw it very much, understandably, as their future income.
  • There were almost no efforts in the country at the time to use basic queuing theory
  • We made a series of recommendations, including much more work on the research about benchmarks. Can we actually define a legitimate benchmark where, if missed, the evidence would be that morbidity or mortality is increasing? There remains very little work done in that area, and that becomes a major problem in moving forward into other benchmarks.
  • the whole process needed to be much more multidisciplinary in its focus and nature, much more team-based
  • the issue of appropriateness
  • Some research suggests the number of cataracts being performed in some jurisdictions is way beyond what would be expected to be needed
  • the accord did a very good job with what we do, but a much poorer job around how we do it
  • Most importantly, the use of single lists is needed. This is still not in place in most jurisdictions.
  • the accord has bought a large amount of volume and a little bit of change. I think any future accords need to lever any purchase of volume or anything else with some capacity to purchase change.
  • We have seen volumes increase substantially across all provinces, without major detriment to other surgical or health care areas. I think it is a mediocre performance. Volume has increased, but we have not changed how we do business very much. I think that has to be the focus of any future change.
  • with the last accord. Monies have gone into provinces and there has not really been accountability. Has it made a difference? We have not always been able to tell that.
  • There is no doubt that the 2004-14 health accord has had a positive influence on health care delivery across the country. It has not been an unqualified success, but nonetheless a positive force.
  • It is at these transition points, between the emergency room and being admitted to hospital or back to the family physician, where the efficiencies are lost and where the expectations are not met. That is where medical errors are generated. The target for improvement is at these transitions of care.
  • I am not saying to turn off the tap.
  • the government has announced, for example, a 6 per cent increase over the next two or three years. Is that a sufficient financial framework to deal with?
  • Canada currently spends about the same amount as OECD countries
  • All of those countries are increasing their spending annually above inflation, and Canada will have to continue to do that.
  • Many of our physicians are saying these five are not the most important anymore.
  • they are not our top five priority areas anymore and frankly never were
  • this group of surgeons became wealthy in a short period of time because of the $5.5 billion being spent, and the envy that caused in every other surgical group escalated the costs of paying physicians because they all went back to the market saying, "You have left us out," and that became the focus of negotiation and the next fee settlements across the country. It was an unintended consequence but a very real one.
  • if the focus were to shift more towards system integration and accountability, I believe we are not going to lose the focus on wait times. We have seen in some jurisdictions, like Ontario, that the attention to wait times has gone beyond those top five.
  • people in hospital beds who do not need to be there, because a hospital bed is so expensive compared to the alternatives
  • There has been a huge infusion of funds and nursing home beds in Ontario, Nova Scotia and many places.
  • Ontario is leading the way here with their home first program
  • There is a need for some nursing home beds, but I think our attention needs to switch to the community resources
  • they wind up coming to the emergency room for lack of anywhere else to go. We then admit them to hospital to get the test faster. The weekend goes by, and they are in bed. No one is getting them up because the physiotherapists are not working on the weekend. Before you know it, this person who is just functioning on the edge is now institutionalized. We have done this to them. Then they get C. difficile and, before you know, it is a one-way trip and they become ALC.
  • I was on the Kirby committee when we studied the health care system, and Canadians were not nearly as open to changes at that time as I think they are in 2011.
  • there is no accountability in terms of the long-term care home to take those patients in with any sort of performance metric
  • We are not all working on the same team
  • One thing I heard on the Aging Committee was that we should really have in place something like the Veterans Independence Program
  • some people just need someone to make a meal or, as someone mentioned earlier, shovel the driveway or mow the lawn, housekeeping types of things
  • I think the risks of trying to tie every change into innovation, if we know the change needs to happen — and there is lots of evidence to support it — it stops being an innovation at that point and it really is a change. The more we pretend everything is an innovation, the more we start pilot projects we test in one or two places and they stay as pilot projects.
  • the PATH program. It is meant to be palliative and therapeutic harmonization
  • has been wildly successful and has cut down incredibly on lengths of stay and inappropriate care
  • Where you see patient safety issues come to bear is often in transition points
  • When you are not patient focused, you are moving patients as entities, not as patients, between units, between activities or between functions. If we focus on the patient in that movement, in that journey they have through the health system, patient safety starts improving very dramatically.
  • If you require a lot of home care that is where the gap is
  • in terms of emergency room wait times, Quebec is certainly among the worst
  • Ontario has been quite successful over the past few years in terms of emergency wait times. Ontario’s target is that, on average, 90 per cent of patients with serious problems spend a maximum of eight hours in the emergency room.
  • One of the real opportunities, building up to the accord, are for governments to define the six or ten or twelve questions they want answered, and then ensure that research is done so that when we head into an accord, there is evidence to support potential change, that we actually have some ideas of what will work in moving forward future changes.
  • We are all trained in silos and then expected to work together after we are done training. We are now starting to train them together too.
  • The physician does not work for you. The physician does not work for the health system. The physician is a private practitioner who bills directly to the health care system. He does not work for the CEO of the hospital or for the local health region. Therefore, your control and the levers you have with that individual are limited.
  • the customer is always right, the person who is getting the health care
  • It is refreshing to hear something other than the usual "we need more money, we absolutely need more money for that". Without denying the fact that, since the population and the demographics are going to require it, we have to continue making significant investments in health, I think we have to be realistic and come up with new ways of doing things.
  • The cuts in the 1990s certainly had something to do with the decision to cut support staff because they were not a priority and cuts had to be made. I think we now know it was a mistake and we are starting to reinvest in those basic services.
  • How do you help patients navigate a system that is so complex? How do you coordinate appointments, ensure the appointments are necessary and make sure that the consultants are communicating with each other so one is not taking care of the renal problem and the other the cardiac problem, but they are not communicating about the patient? That is frankly a frequent issue in the health system.
  • There may be a patient who requires Test Y, X, and Z, and most patients require that package. It is possible to create a one-stop shop kind of model for patient convenience and to shorten overall wait times for a lot of patients that we do not see. There are some who are very complicated and who have to be navigated through the system. This is where patient navigators can perhaps assist.
  • There have been some good studies that have looked at CT and MRI utilization in Ontario and have found there are substantial portions where at least the decision to initiate the test was questionable, if not inappropriate, by virtue of the fact that the results are normal, it was a repeat of prior tests that have already been done or the clinical indication was not there.
  • Designing a system to implement gates, so to speak, so that you only perform tests when appropriate, is a challenge. We know that in some instances those sorts of systems, where you are dealing with limited access to, say, CT, and so someone has to review the requisition and decide on its appropriateness, actually acts as a further obstacle and can delay what are important tests.
  • The simple answer is that we do not have a good approach to determining the appropriateness of the tests that are done. This is a critical issue with respect to not just diagnostic tests but even operative procedures.
  • the federal government has very little information about how the provinces spend money, other than what the provinces report
  • should the money be conditional? I would say absolutely yes.
healthcare88

Private health care a big mistake - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|cbpo|20161015|258398912

Day privatization court

shared by healthcare88 on 17 Oct 16 - No Cached
  • Sat Oct 15 2016
  • While I must seriously disagree with Dr. Harry Pollett's letter to the editor in the Cape Breton Post ("Doctor offers support for private health care," Sept. 30), I do thank him for raising the issue of a parallel health system, i.e. a private-for-profit system. It came as no surprise that the Fraser Institute was referenced as supportive of such a system. Their idea of downloading health care innovation on individual provinces and territories as a way to "set the provinces free" begs the question, "free from what?" As pointed out in the Cape Breton Post of the same day, Canada's premiers, while pleading with the federal government to meet with them to collaborate on health care, tell us that impending changes, set to be implemented next year, will cost the provinces as much as a billion dollars. Innovating while being cut to the bone may be difficult.
  • And a "private-for-profit" system will get their specialists from where? With the losses we have already experienced, I'm not sure we have many more to give. And should Dr. Brian Day and his cohorts be successful and able to provide quick fixes to "suitable patients" who can afford their service for knees, hips and the like, I would suggest that wait times for those unable to pay will be even longer with the loss of specialists to private clinics. With the acceptance of "screened" patients, these clinics would almost certainly be extremely profitable, having a big turnover with shorter hospital stays and wait times. All this while leaving the public system to treat patients with more serious illnesses, requiring longer hospital stays, and fewer dollars to work with - the type of care that is costly, but which a caring society considers as essential. Yes, there is waste in our system. When drugs can receive a 20-year patent protection guaranteeing as much as a 1,500 per cent profit margin, when we have people forced to remain in hospital because we have no other facility to meet their needs, and when the one body that could truly help coordinate a national system based on the principles of the Canada Health Act refuses to meet with the provinces and territories, we have duplication, waste and an inability to deal from strength with pharmaceutical companies. We could go on, and I'm sure Dr. Pollett could make additional suggestions.
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  • In his concluding remarks, Canadian Medical Association (CMA) president Dr. Granger Avery posed this question recently at the Canada 2020 Summit: "Is it fair to place the full burden of health care costs on governments?" Does the CMA not realize that we pay for our health care through our taxation system? What we need is a coordinated health system based on the principles of the Canada Health Act with doctor, hospital and drug care available to all Canadians no matter where they live and how much money they have. While Dr. Day may in fact be successful, I for one do not wish him success. My wish is that the people we elect will see the need for leadership in improving a system we can indeed be proud of. Dr. Tom Gaskell
  • Bras d'Or (Past president of the Canadian Association of Retired Teachers)
Govind Rao

P3 Model Proven to Deliver World-class Health Care Infrastructure - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20150924|229942557

from heather p3 privatization

shared by Govind Rao on 24 Sep 15 - No Cached
  • National Post Thu Sep 24 2015
  • The foundation of public-private partnerships, or P3s, in Canada was firmly cemented 20 years ago with the construction of the Confederation Bridge. Since then, hundreds of P3 projects have been built in almost every province, with the majority of those being health care facilities. In B.C. alone, there have been about 19 such health care projects, including two hospitals on Northern Vancouver Island currently under construction. P3 projects are also underway in Alberta, along with a new hospital in North Battleford, Saskatchewan.
  • According to Amanda Farrell, President and CEO of Partnerships BC, health care projects are well suited to P3s, because of their inherent complexity. "There are a lot of complex mechanical and electrical requirements with these buildings," says Farrell. "There are infection control issues to consider, and health care equipment has very specialized and sophisticated needs."
  • ...9 more annotations...
  • P3s help manage a project's scope, schedule, and budget, and shifts much of the risk to the private sector. In return the public benefits from facilities that are built on time and on budget, but the value of the P3 model goes far beyond the construction of a building, it lives on for decades in the operation and maintenance of the facility. "In the past, we've seen infrastructure deficits with a lot of our facilities, because of deferred maintenance" says Farrell. "But with a P3, a standard of performance quality in maintaining the asset continues for the life of the agreement, which typically is 30 years."
  • P3s well-suited to health care environment While Farrell concedes that P3s suit some projects better than others, such as new hospital builds, she has seen a lot of innovation with health care P3s because of the collaboration between industry and clinical stake-
  • holders during the development of bid proposals. Clinical planners work with the design and construction team to optimize clinical flow and function, which means the best possible outcome for patients and clinicians. "Industry is bringing world class expertise to these projects," says Farrell, "they have embraced the model, which has led to a lot of success, and we are seeing broad industry participation, with lots of local contractors involved."
  • Kim Johnson, Chief Strategy Officer and Senior VP Commercial and Shared Services at Graham Group credits a supportive political environment and growing public acceptance of private sector involvement for the success of these large projects. "People understand that P3s provide a huge public benefit," he says, "and there is an extensive track record with these types of projects, especially in health care, where there is a critical mass of knowledge and expertise."
  • Collaboration and continual learning lead to successes Canadian jurisdictions looked at what was happening in the UK and Australia in the 1990s with P3s, and refined that knowledge for use domestically. "We've learned from those mature markets, and made it even better, and become a leader globally," Johnson adds. Experience with large projects is that they can often run into problems with design, construction and maintenance, but under a P3 model there is a single production team that is performance based, drives innovation, manages costs, and delivers the project quicker.
  • Two new Ontario health facilities have benefited from the P3 model, most notably the New Oakville and Humber River Hospitals, the prior set to open in the new few months.
  • P3s show positive results Despite the wealth of P3 experience in Canada, there are still some naysayers who say these projects end up costing the public more, and contend that government should just build these facilities on their own.
  • "We think it's simplistic to say that a P3 costs more in the long run than if government just built the projects on their own, because they are not taking into account the risk factor that is passed on to the private sector and the long-term cost of operating and maintaining facilities, which is built into the P3 agreement," says Farrell. "Under the right circumstances, P3s have been proven to deliver value for money."
  • Johnson echoes those comments and adds that government could build these projects on their own but they will end up costing more. He adds, "with a P3, you can deliver the same project in less time and at less cost."
Govind Rao

A human face of lengthy waits for surgery; Reducing these times can be done - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|cahr|20150822|227618245

from heather waits Alberta bc privatization

shared by Govind Rao on 24 Aug 15 - No Cached
  • Calgary Herald Sat Aug 22 2015
  • Robert L. Brown
  • I spent my life teaching actuarial science at a university. As a result, I calculated lots of numbers: averages, expected values, variances. But, they were only numbers. What I didn't see was the individual human story behind each calculation. But now that I am the human face within one of these distributions, I see it all in a different light. The distribution I am now studying is the wide variability of Canadian health-care delivery relevant to hip replacements. Some background: I entered the official hip replacement list in Victoria, B.C., on July 23, 2014. I was told to expect a wait time of 12 to 18 months. But was that good or bad? Was it necessary? I investigated.
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  • Data show that for hip replacements, B.C. has the second longest wait times in Canada, with a median value of 70 weeks. But that is a median value, which means about half of all patients wait longer. That is twice the wait time in Ontario, which is actually the third best province in Canada, according to recent Canadian Institute for Health Information (CIHI) statistics. So, I waited and the hip deteriorated until painkillers seemed useless.
  • Finally, just short of a year, I got a call on June 10 to say that my hip surgery was scheduled for July 15, or week 51. I fought back tears of relief. It almost made me forget the absence of a vital life during the weeks I had waited. What happened next knocked the wind out of my sails. One week before my scheduled operation, I was told that I had been bumped for a situation that presented a "higher level of urgency." They had just added almost eight weeks to my wait time for reasons that were opaque, at best, and without logic to me. Why did this happen? In the end, I got no real answers.
  • So, beyond my personal experience, the real question is: "Are Canadian wait times for hip replacement justified or could they be shortened?" Turns out, the variability within Canada's health-care system is wide, and does not just exist across provincial borders. In most provinces, wait times vary significantly from city to city, region to region, hospital to hospital and doctor to doctor. The evidence tells us that having a "private" alternative actually makes wait times in publicly funded health care facilities worse. So that is not the solution.
  • One of the problems in answering this question is a lack of provincewide databases in many jurisdictions. Such databases would help minimize wait times because patients from a busy facility in one region within a province could be transferred to other facilities (or surgeons) with shorter waiting lists. Today, in most provinces, doctors and specialists work in silos and there is no real overarching management of the system. Health care decision-making in Canada is largely decentralized, with few standardized measures of "success." One doctor can have wait times measurably better or worse than the next, and the system cannot be expected to respond well by moving individual patients. The only real leverage many provincial ministries impose is to incent desired behaviour through macrobudgets.
  • We need more integrated management and measurement in the system - if not countrywide, then at least provincewide. Alberta is a good model. Most recent data show that providing incentives tied to provincial benchmarks based on a standardized care path has created savings of almost 12,600 hospital bed days (and $13 million) annually. The incentive? The non-monetary savings in resources are pumped back into hip and knee replacement services, where the medical teams see the impact of their success first-hand, rather than disappearing back into the system as a whole. Alberta now meets CIHI benchmarks for hip replacements 87 per cent of the time, versus a 67 per cent success rate in B.C. In fact, for 90 per cent of its hip replacement patients, Alberta now meets the maximum wait-time limit criterion of 14 weeks. Note that providing financial compensation is not necessarily the primary motivating factor.
  • Canadians consistently show strong support for their health-care system. However, wait times continue to drag the outcomes down. We can shorten wait times, but it will take political courage. Let's hope that courage can be found. Robert Brown is an expert adviser with EvidenceNetwork. ca, a retired professor of actuarial science at the University of Waterloo and immediate past president of the International Actuarial Association. He lives in Victoria, B.C.
Govind Rao

Private sector should get behind Ottawa's 'development finance initiative' - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150522|221008100

from heather privatization

shared by Govind Rao on 26 May 15 - No Cached
  • The Globe and Mail Fri May 22 2015
  • Done poorly, this initiative could become a slush fund for unproductive, politically driven subsidies. Even worse, it could become a competitor to private financiers, equity investors and insurers. Despite this initiative's great potential, success is not assured, which is why private investors need to work with the federal government to ensure this initiative realizes its full promise. Every other Group of Seven country and most Organization for Economic Co-operation and Development industrialized countries have operated similar "blended" public-private initiatives for decades. All of the G7's development finance institutions (DFIs) are profitable. Some roll these profits back into their national treasuries; others use their returns to finance expanded public-private collaborations and growth in their public grant aid.
  • Now it's time to turn these good intentions into action. Development organizations have weighed in, cautioning that this initiative shouldn't be a substitute for Canada's grant aid. They're right to be concerned: Canadian official development assistance fell to a recent low of 0.24 per cent of gross domestic product in 2014 as a result of an ongoing freeze on new budget allocations. Aid and private, profit-driven investment need to work together to build integrated development solutions to extreme poverty. To function well, private business needs public investments in health, education and infrastructure - good things that don't produce a return that's easy for a company to capture. And the public sector needs the private sector to provide a dynamic engine of growth: As the World Bank points out, about 90 per cent of jobs in developing countries are already created by private capital. Canada should increase its public and private international development financing in tandem.
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  • Doing so requires the business community to engage with the Department of Foreign Affairs, Trade and Development and EDC in the effective design and implementation of the government's new initiative. Done well, this initiative could leverage Canada's strengths in finance, natural resources, infrastructure construction and engineering to catalyze private investment that will accelerate the global push toward the United Nations' Sustainable Development Goals (SDGs). The initiative could also build on the skills and experience of Canada's large immigrant communities to strengthen trade and investment links with emerging and frontier markets - countries that are now responsible for the lion's share of global growth, but where Canada's business presence is tiny.
  • Senior fellow at the Jeanne Sauve Foundation and visiting scholar at Massey College in the University of Toronto. He tweets at @BrettEHouse. In its 2015 Economic Action Plan, the federal government announced its intention to create a $300-million, five-year "development finance initiative" to partner with private capital to create growth and jobs in low-income countries. The budget document anticipates that this initiative - to be located within an expanded Export Development Canada (EDC) - will provide a mix of financing, technical assistance and business advisory services to enterprises operating in line with the government's international assistance priorities.
  • As outlined in a submission to Parliament last summer by the Centre for International Governance Innovation and Engineers Without Borders, the experiences of Canada's G7 counterparts offer some important lessons for Ottawa's initiative. An effective initiative should address market failures; that is, it should fill gaps in the financial system that prevent good projects, sound businesses and effective entrepreneurs from obtaining the financing they need on reasonable terms. A classic example would be the situation of new immigrant entrepreneurs: They know their former countries well, they are ideally placed to build links between Canada and their birthplaces, but their lack of Canadian credit history makes it difficult for them to gain access to affordable borrowing to grow their businesses. Ottawa's new initiative will need to be empowered with a full range of financial tools - a variety of lending instruments, a mandate to take equity positions, the ability to write guarantees, the option to underwrite insurance products - that it can tune flexibly to take projects from their early days to full bankability.
  • It needs to be risk-loving and clear-eyed about the fact that some projects will fail, and maintain a long horizon on investments that typically take many years to pay out returns and development impact. This new development finance initiative should also embrace open competition. The most successful DFIs work with the most effective firms on the most innovative projects.
  • They're not limited to working with their own nationals. Both Canada and developing countries will benefit most if this initiative is made accessible to the best people, ideas and execution. Finally, Canada's new development finance initiative needs to take poverty reduction just as seriously as profit generation. Most other DFIs do this imperfectly, at best; some don't even monitor the impact of their projects on development. This makes no sense. Development is good for business and business can be good for development.
  • Five years from now, development gains will be just as important as profits in making the case for renewed funding of this initiative. All these lessons need be adapted to both the needs of Canadian business and Canada's specific development objectives. The Canadian Chamber of Commerce and Canadian Council of Chief Executives have both been important supporters of this project. Now it's time for the businesses that stand to benefit directly from this initiative to get involved ensuring its success.
Govind Rao

It's Okay to Fail in Healthcare As Long As We Learn From Our Mistakes | Danie... - 0 views

www.huffingtonpost.ca/...thcare-strategy_b_6808722.html

from heather medicare

shared by Govind Rao on 06 Mar 15 - No Cached
  • March 6, 2015
  • Forty is the new thirty. Orange is the new black. And failure is the new success.It seems these days that no success story is complete without a failure (or two) along the way: the bankruptcy that gave birth to a successful company; the entrepreneur who lost it all just before hitting the Fortune 500. Entire issues of the Harvard Business Review and the New York Times Magazine have been devoted to failure. In the business world leaders are often told: "Fail fast, fail early, fail often."
Heather Farrow

Breaking News: Success! Patients, Residents Travel 700 kilometres to Ontario Legislatur... - 0 views

www.ontariohealthcoalition.ca/...hospitals-emergency-department

Ontario coalition hospital cuts victory

shared by Heather Farrow on 20 Apr 16 - No Cached
  • April 18, 2016
  • Toronto – At a press conference today at Queen’s Park, patients and concerned citizens from Wallaceburg issued an urgent plea to Ontario’s Minister of Health to stop the closure of the Wallaceburg Hospital’s Emergency Department. The residents, who are traveling more than 700 kilometres across the province and back to bring their message to Ontario’s Legislature, told their stories of how the Wallaceburg emergency department has saved the lives of their family members and friends. Their local MPP Monte McNaughton greeted them in the Legislature, wrote a letter to the Health Minister advocating to keep the Emergency Department open and delivered hundreds of personal letters from community members to the Premier today.
Irene Jansen

Curing lengthy wait times in the public health system. Calgary Herald. April 29, 2012. - 1 views

umanitoba.ca/...4982

waits teams incentives innovation alberta surgery

shared by Irene Jansen on 30 Apr 12 - No Cached
  • many patients stay in hospital longer than the recommended four-day provincial benchmark for hip and knee surgeries
  • Alberta Health Services devised an experiment in 2010-11 using non-financial incentives to get frontline staff across the province engaged in applying the four-day benchmark.
  • Multidisciplinary teams – surgeons, nurses, therapists and managers – were formed at 12 hospitals in the province where hip and knee surgery is performed.  Each team set out to reduce patient stay to the benchmark while also striving for other creative ways to improve performance. 
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  • Teams tracked their progress on a scorecard, met monthly for review, and shared results with other teams
  • Patients were managed more closely to ensure that they had a plan for coping at home after surgery. Those not medically ready to leave hospital, but not at risk, were moved into sub-acute care.
  • The experiment produced an impressive annualized savings of almost 11,000 acute care bed-days and was quickly adopted by AHS as a permanent program.
  • preliminary results suggest more than 13,500 bed-days have been saved, opening up bed capacity to potentially perform an extra 3,375 hip and knee replacements.
  • The teams’ incentive: a portion of the savings in resources were pumped back into hip and knee replacement services where the teams could see the impact of their success first-hand.
  • Part of the success is rooted in giving frontline health care professionals the means and incentives to participate directly in meeting the four-day benchmark.
  • Public health care suffers from many ailments but, as Canada’s premiers recognized when they formed their Health Care Innovation Working Group in January, it also brims with opportunities if you look in the right places.
Irene Jansen

Leading LEAN: A Canadian Health care Leaders Guide by Benjamin A. Fine et al - 0 views

schowengerdtconsulting.com/...%20Care%20Leader's%20Guide.pdf

hhr lean

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Irene Jansen on 23 Jan 12
     
    Healthcare Quarterly Vol. 12, No.3, 2009 -management strategy from Toyota -study of five Canadian health care providers -successes and obstacles identified
Irene Jansen

CLC convention resolutions 2011 - 0 views

www.canadianlabour.ca/...-and-social-policy-resolutions

union

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Irene Jansen on 23 Jan 12
     
    A resolution to the last CLC convention on renegotiation of federal transfers was referred to the CLC Canadian Council (new name for the CLC Executive). There were a number of related resolutions passed at the CLC convention: Policy Paper: Building on Our Success, Policy Paper: Good Jobs for All, Public Medicare and Pharmacare, and CETA. Another resolution referred to the CLC Canadian Council addresses public infrastructure and public services.
Irene Jansen

Call for Innovative Practice Stories - CPhA - 0 views

www.pharmacists.ca/...or-innovative-practice-stories

innovation pharmacists utilization

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Pharmacy Practice Innovative Showcase – CPhA is looking to showcase creative professional services that contribute to the development and advancement of pharmacy practice and positive patient outcomes
  • Irene Jansen on 23 Jan 12
     
    innovative practice story: 1. Patient-care need addressed. 2. Innovative pharmacy service/initiative and how it was implemented. 3. How did the service/initiative affect patient outcomes and your pharmacy practice? 4. Was the service/intervention successful? Has it been reproduced in or expanded to other settings? 5. Barriers to implementation and lessons learned.
Irene Jansen

Social Affairs, Issue 5 - Evidence - October 27, 2011 - 0 views

www.parl.gc.ca/...05evb-e.htm

doctors education primary health care innovation accord hhr senate

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Dr. Paul Armstrong, Founding and Former President, Canadian Academy of Health Sciences
  • As an example of these accomplishments, I would cite the work of CIHR funded researcher Dr. Cyril Frank and his team at the Alberta Bone and Joint Health Institute, who developed a new and more cost-effective model of care for hip and knee replacement. This model has markedly improved outcomes while decreasing hospital stays and wait times for surgery. For governments, the cost savings from a nationwide implementation of this model of care is estimated at approximately $228 million per year.
  • CIHR, in partnership with the provinces, universities, disease charities and the private sector, will be investing in a 10-year initiative to transform community-based primary health care.
  • ...10 more annotations...
  • It will be the largest scale initiative ever undertaken in Canada. Within five years, it will involve 30 per cent of Canadians from coast to coast, testing new innovative models of care, monitoring success and engaging a national and international network of senior policy-makers to investigate the conditions that will be necessary to scale up successful models of care. We will no longer be a country of pilot projects.
  • Dr. Armstrong: What we propose in our assessment is to redesign the way the health professions work with each other. As opposed to solo practitioners, we believe they should be integrated, and we believe this requires a substantial cultural change because the historical divisions around scopes of practice have led to a silo mentality, and the future is clearly an integration one.
  • Assuming we have an accord in 2014 to succeed this one, and assuming similar funding methods are used, what are the main proposals or incentives you think should be put to the provinces?
  • Dr. Armstrong: I believe we need to establish national standards and make our system accountable. We need to measure those standards. We need to get return on our investment that is more meaningful than we have in the past, and we need to emphasize innovative transformative change, then publish the results on an annual basis.
  • one of the gaps you are referring to is the lack of a robust, country wide technology assessment system
  • We take it for granted that we practice evidence-based medicine, but in fact we do that only in part.
  • We talk about 5 million Canadians not having access to a family doctor, but they should have access to an integrated health care team where the first point of care would not necessarily be a physician.
  • Public health interventions aimed at improving quality of lifestyle, food security and tax reforms with respect to sales tax on foods will be a way forward.
  • Not all physicians should be trained the same way and, indeed, for many the training is too long.
  • Dr. Tamblyn: I think you need to focus on the outcomes you are wanting to achieve in accordance with basic principles that we have been known for internationally, which is equitable access, appropriate care and so on, but you need to focus on preventing disease, reducing disparities and improving outcomes, and then you need to put something in an innovation fund to actually make that happen.
Govind Rao

Premiers still taking baby steps - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|233679|ntgm|20130803|174708662

from heather accord

shared by Govind Rao on 07 Aug 13 - No Cached
  • Govind Rao on 07 Aug 13
     
    The Globe and Mail Sat Aug 3 2013 According to their self-congratulatory communiqué, the "quality and sustainability of Canada's health care systems are being improved" by the efforts of the Premiers of the 13 provinces and territories. In the year since the Council of the Federation (the name given to the Premiers' confab) appointed a health-care innovation working group, it has "achieved a number of successes," according to the release. These include lowering the price of prescription drugs, reviewing the appropriateness of seniors care, and examining opportunities to expand the roles of paramedics and pharmacists. Let's give the Premiers credit for correctly identifying three key areas that need urgent attention in Canada's health system: improving access to and affordability of prescription drugs; bolstering the long-term care system; and creating some kind of coherent health human resources strategy so that we have the work force we need in the future.
Govind Rao

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

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

from heather Quebec doctors cuts privatization

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

Keep Saskatchewan Public Conference huge success | Canadian Union of Public Employees - 0 views

cupe.ca/public-conference-huge-success

from heather Saskatchewan cupe conference privatization

shared by Govind Rao on 24 Apr 15 - No Cached
  • Apr 23, 2015
  • From April 20 to 21, over 70 activists gathered in Saskatoon to learn about the threats we face from privatization and to take action to protect public services. The Canadian Centre for Policy Alternative’s Simon Enoch started things off with a startling look at how much privatization has actually occurred in Saskatchewan. Since 2007 there have been over 50 occurrences of privatization, including contracting out of hospital laundry and private liquor stores and contracting out within Crown Corporations.
Govind Rao

Charming, intelligent leader fell from grace; Multimillion-dollar McGill University Hea... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150718|225111270

from heather p3 Quebec hospital fraud

shared by Govind Rao on 21 Jul 15 - No Cached
  • The Globe and Mail Sat Jul 18 2015
  • When his death from cancer was announced earlier this month, people still doubted that Arthur Porter, the bow-tied former CEO of Montreal's McGill University Health Centre, had really died. After all, the "golden boy" with the silver tongue who was tarnished by a multimilliondollar fraud scandal had spent two years languishing in a notorious Panama prison as he fought extradition back to Canada. "If anyone could pull a fast one, why not the man who prided himself on his ability to make an environment suit him rather than the other way around? And so members of Quebec's anti-corruption unit trooped down to the tropical country to view the body, allaying the suspicions.
  • "Dr. Porter was 59 when he died in a Panamanian hospital on June 30, an ignominious, sad and lonely end for a man who had found success far from his birthplace in Sierra Leone. At Cambridge, he was a star medical student. In the United States, where he ran a major medical centre in Detroit, he was a self-declared Republican who in 2001 refused an offer from then-president George W. "Bush to become the next surgeon-general. In his 2014 memoir, The Man Behind the Bow Tie, Dr. Porter recalled getting a phone call soon after. ""Is that your final answer?" Mr. Bush reportedly asked him, lifting a line from Who Wants to be a Millionaire, at the time a popular TV game show.
  • ...7 more annotations...
  • "Rotund, funny and occasionally pompous, Dr. Porter was everyone's friend and nobody's confidante, the life of the party and an agile dancer, both in political circles and around a ballroom floor. A member of Air Canada's board of directors, he travelled the world free. His former friend Prime Minister Stephen Harper had him sworn in as a member of the Privy Council so he could serve as chairman of the Security Intelligence Review Committee, or SIRC, the country's spy watchdog agency. "And he was close to Quebec Premier Philippe Couillard, a relationship that began in 2004 when the politician, a neurosurgeon by training, was provincial health minister. Like many of Dr. Porter's friendships, theirs ended with the news of the hospital's megacost overrun and a $22.5-million fraud inquiry connected to the MUHC's decision to award the construction contract to a consortium led by the Montreal-based engineering firm SNC-Lavalin Group Inc.
  • ""In a way, Arthur was like Icarus, who came crashing down to earth when his wax wings melted because he flew too close to the sun," Jeff Todd, an Ottawabased journalist who first met Dr. Porter in the Bahamas and co-authored the memoir, said. ""He told me that if he did anything wrong, it was to go way too fast," Mr. Todd continued. "There was never a peak he didn't want to climb and if there was a huge challenge, he always thought he would simply fly over it. But he couldn't always do that." "The first indication was in November, 2011, when the National Post revealed he had signed a commercial agreement the year before with Ari BenMenashe, a Montreal-based Israeli security consultant and arms dealer, all while he was head of both the MUHC and Canada's spy watchdog. Mr. BenMenashe was to secure a $120million grant from Russia for "infrastructure development" in Sierra Leone. In return, a company called the Africa Infrastructure Group, which was controlled by Dr. Porter's family, would manage what he wrote were "bridges, dams, ferries and other infrastructure projects" built with the Russian money.
  • "Within days, he was gone from SIRC. Less than a month later, he resigned from the MUHC, departing on the grounds that he had accomplished what he had set out to do in 2004: bring together a private-public partnership and get a long-dreamed-of facility built. "Unbeknownst to the public at the time, under his watch, a planned project deficit of $12million had somehow escalated to $115-million. "The following year, fraud charges were laid, but by then Dr. Porter was on to other projects and living in a gated community in the Bahamas, where he had maintained a home for years. After Interpol issued a warrant for his arrest, he and his wife, Pamela Mattock Porter, were detained June, 2013, by authorities at Tocumen International Airport in Panama City. "Despite claiming he could not be arrested because he was on a diplomatic mission for Sierra Leone, he was soon confined to overcrowded quarters in a wing reserved for foreigners in filthy La Joya prison. Toting an oxygen tank, he became known there as "Doc," ministering to inmates who included drug dealers and murderers. The man who had begun his ascent to the top as a doctor beloved by his patients would end at the bottom as a doctor beloved by his patients again.
  • "He was smart, perhaps too smart for his own good, and affable, with an ability to zero in on the most powerful person in the room with laser-like focus. His long-time friend and former teacher Karol Sikora, who partnered with Dr. Porter in a Bahamian medical clinic and is also the medical director of their joint private health-care company, Cancer Partners UK, said he was uncannily good at getting people together everywhere he touched down, even if they had opposing views. ""People like that are rare and they are very good at running big institutions," Dr. Sikora said. ""Arthur reached the peak of his career in 2010, when he was all glowing and bigger than sliced bread. Then it all went wrong." "Although Dr. Porter claimed the money from SNC was payment for other consulting work he'd done for them, his friend opined that the truth will probably never come out now. ""I'd like to think Arthur was never part of this monkey business, but we'll never know," he said.
  • "Others were not so kind. Responding to news of his death, the MUHC issued a terse statement that extended condolences to his family and offered no further comment, while Mr. Harper suspended the protocol that would have seen the Peace Tower flag fly at half-mast to mark the death of a Privy Council member. "In prison, living in unsanitary surroundings and denied proper treatment in a hospital for the cancer that many doubted he had, Dr. Porter, who leaves his father, sister, wife and four daughters, was outwardly still full of bravado until near the end. ""I just have to survive and make do," he told CBC reporter Dave Seglins in a phone interview in March that revolved around his treatment at the prison and his successful complaint to the United Nations torture watchdog that his human rights were being trampled on. ""[The] water, food, bedding and the fact that one has to urinate in a bucket shared by about 50 to 100 people ... for someone who has an illness and needs treatment, it was pretty obvious, I presume, the UN clearly found in my favour." "In addition, Dr. Porter continued, his raspy voice rising, he had not had a single court hearing in 22 months.
  • "I've never left here to go into the city. I have no idea what the inside of a courtroom looks like, not in Panama, Canada, the Bahamas or anywhere," he cried. "I've never been to court in my life." "In the end, though, he seemed to be aware that the stain on his reputation would not be erased, not even in death. ""My entire life has been devoted to climbing, winning and succeeding," he wrote in his memoir. "But with the end drawing near, it is inevitable that I, like anyone else, wonder if what I have accomplished truly matters. I wonder how I will be remembered." "To submit an I Remember: obit@globeandmail.com Send us a memory of someone we have recently profiled on the Obituaries page. Please include I Remember in the subject field.
  • "In his memoir, Dr. Porter said his life was 'devoted to ... winning.' " "Arthur Porter, left, chats with Stephen Harper at Montreal General Hospital in 2006. The Prime Minister had Dr. Porter sworn in as a member of the Privy Council.
Govind Rao

New poverty reduction strategy calls for guaranteed income for more than just seniors -... - 0 views

www.digitaljournal.com/1647760

from heather determinants poverty seniors

shared by Govind Rao on 19 Dec 13 - No Cached
  • Dec. 18, 2013
  • CALGARY, Dec. 18, 2013 /CNW/ - Guaranteed annual income programs for seniors are a policy success story for Canada as it boasts one of the world's lowest poverty rates among the elderly. A new report funded by the Canadian Institutes of Health Research and released by The School of Public Policy recommends these programs be extended to a much larger age group. "The government could go a lot further toward the reduction of poverty in Canada by building on the success of its income supports for seniors, and making them available to poor Canadians of all ages," authors Herb Emery, Valerie Fleisch and Lynn McIntyre write. Of course, this move would be a reversal in policy given that the federal government is currently phasing in a plan to raise the age of eligibility for Old Age Security from 65 to 67.
Govind Rao

Medicare can rise to meet its challenges; Learning from and implementing successful inn... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|243387|edjn|20140807|201718016

from heather medicare ally

shared by Govind Rao on 07 Aug 14 - No Cached
  • Edmonton Journal Thu Aug 7 2014
  • Let's commit to learning from the lessons of successful health-care innovations and explore implementing them across the country. It's time to roll up our sleeves and help make medicare better care. Monica Dutt chairs the Canadian Doctors for Medicare, a public health and family physician, and is based in Cape Breton, Nova Scotia. Vanessa Brcic is a board member with the Canadian Doctors for Medicare, a family physician and a clinician scholar in the department of Family Practice at the University of British Columbia in Vancouver.
Govind Rao

Prince Albert Health Care Festival Huge Success | Canadian Union of Public Employees - 0 views

cupe.ca/lth-care-festival-huge-success

from heather cupe Saskatchewan privatization campaign accord

shared by Govind Rao on 11 Sep 14 - No Cached
  • Over a thousand people came out to the Prince Albert Keep Health Care Public Festival to listen to great bands, eat some good food and learn about the threats to public health care. Though Saskatchewan is the home of medicare in Canada, public health care is facing large scale threats. In Prince Albert, over 100 hospital laundry workers are going to be losing their jobs due to privatization. In May of last year, the provincial government decided to privatize all hospital laundry in the province and contract it out to a profit seeking Alberta company called K-Bro Linens.
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