Other issues raised include: using for-profit business models to deliver social programs to those who need them most; promoting profits from social ills; and the danger of stable, long-term publicly funded programs being displaced by short-term, profitable initiatives.

Read CUPE’s submission to HRSDC

any physicians found to have fast-tracked patients for reasons other than medical need could face discipline ranging from a reprimand to the loss of their licence.

"deinstitutionalization," resulted in the virtual emptying, and subsequent closure, of many psychiatric facilities across the country (Can J Psychiatry 2012;57[2]:Insert 1-6).

The comprehensive community support systems that were meant to sustain deinstitutionalization never fully materialized.

In 1959, the nation had 65 000 beds in mental health facilities (Can J Psychiatry 2012;57[2]:Insert 1-6). Today, there are just 10 653 beds (www.who.int/mental_health/evidence/atlas/profiles/can_mh_profile.pdf).

But transinstitutionalization isn’t the sole factor at play in the disproportionate incarceration of the mentally ill, several experts say. They point to Prime Minister Stephen Harper’s "get tough on crime agenda" as also having had a substantial impact on the numbers of incarcerated.

As a corollary, the conditions of confinement essentially increase the rate of mental illness

Bottom line – what they have promised here is a rounding error in the overall health care budget.

“we need to triple the number of long-term care beds in our province” over the next 20 years

Susan Eng, of the senior advocacy group CARP, said all the recommendations hold promise

The 198-page report by Dr. Samir Sinha, director of geriatrics at Mount Sinai and the University Health Network Hospitals, recommended the Health Ministry explore an income-based system for home care and community support services.

report, Living Longer, Living Well

a report, Living Longer, Living Well

“I think it is time for us to have that conversation. We have moved to that on drugs for example in the last budget,” Matthews said, adding later that “nobody got too excited about it

there already is a user fee for Meals on Wheels

In Britain the coalition has mimicked this approach. Circle, backed by private equity firms, runs Hinchingbrooke hospital in Cambridge.

Since 2010 private companies have had the right to set up large GP-style services

Corporates have set up 200 healthcare centres in two years, although critics point out that the majority have been in wealthier urban areas.

The Social Democrats, the main Swedish opposition party, have given up the idea of renationalising the health service and instead argue that profits should be capped and quality of care more tightly regulated.

more than 500 beds are being removed from the country's best known health centre, the Karolinska University hospital, and the services are being moved into the community to be run by private companies

a business-backed research institute, the Centre for Business and Policy Studies, looked at the privatisation of public services in Sweden and concluded that the policy had made no difference to the services' productivity. The academic author of the report, who stood by the findings, resigned after a public row.

Last year Stockholm county council, which controls healthcare for a fifth of the Swedish population, withdrew contracts from a private company after staff in a hospital were allegedly told to weigh elderly patients' incontinence pants to see if they were full or could be used for longer.

Swedish tax authorities are, however, taking some companies to court because pay in private equity groups is often linked to the profits made on deals and has been incorrectly taxed for years, it is said, at rates lower than that required for income in Sweden.

unmet needs for assistance are associated with higher risk for injuries, having depression, falls and institutionalization.

the private sector expects to win £20 billion of business from the NHS, according to the corporate finance adviser Catalyst

a few gluttonous companies—Virgin Care, Serco, Care UK—have secured dominant positions in the market

The biggest privatisations are taking place in community health services.

Local NHS bodies have already been instructed to outsource 39 types of service. Dubbed the “39 steps to privatisation,” this covers everything from autism care to wheelchair provision.

privatisation favours a few big winners over the co-ops, charities and social enterprises

Many Hospital Trusts are being pushed to the financial brink by the disastrous legacy of the Private Finance Initiative (PFI)

In a first for the private sector, in February 2012 Circle took over an entire general hospital at Hinchingbrooke in Cambridgeshire. The hospital has since fallen 19 places in the patient satisfaction rankings and its finances have worsened, forcing Circle to ask for a bailout after just six months. Despite being prepared to make a potential 20 percent cut to the hospital’s workforce, and while mostly owned by investment funds operating out of tax-havens like the Caymen Islands, Circle nevertheless vaunts its friendly-sounding business model under which doctors and nurses are given part-ownership of the company.

another controversial aspect of the Health and Social Care Act—the ability for NHS hospitals to earn half their income from private patients

revealed a tragic case where a consultant left half way through a dangerous birth to carry out a private caesarean section. The baby later died.

many of the dominant players in the new market are owned by ruthless private equity firms

the collapse of the Southern Cross care-home company

All of this comes before the most high-profile part of the Health and Social Care Act has even been fully implemented—the replacement of PCTs with Clinical Commissioning Groups (CCGs)

largely unaccountable new groups, who will in turn outsource the work to privatised “commissioning support units”

Three multinational companies—LifeLabs, Gamma-Dynacare and CML HealthCare—will receive over 80% of this money.

since private sector corporations are substantially protected by law from the public disclosure of “confidential business information,” increased for-profit delivery has had the effect of decreasing transparency

The experience in Alberta and Saskatchewan provides some indication of the potential harm integration poses for private providers. Over the 15 years since all laboratory services were integrated under the control of the regional governments, the role of for-profit laboratories in Alberta has been significantly diminished, and in Saskatchewan for-profit laboratory provision has effectively ended.

the argument for using public sector institutions, primarily hospitals and public health laboratories, for all laboratory services is straightforward

“there is massive reserve capacity in the hospital laboratories … a fully staffed evening shift could absorb the private laboratories’ workload without difficulty.”

Excess capacity in either the public or private sector is paid for with public funds and, aside from the redundancy necessary to accommodate fluctuations in demand, is a waste.

the Canadian health care system could save a minimum of $250 million per year by moving all publicly funded medical laboratory work into an integrated public non-profit medical laboratory system

added benefits of facilitating the integration of medical records, staff, and administration, and of improving public accountability

Driving down janitorial, security and food service workers wages, which will lead to a more transient workforce, may also compromise service. Evidence from England suggests that slashing hospital cleaners pay lowers cleaning standards and an increased incidence of hospital acquired infections.