Ontario's doctors are calling on government to address the growing crisis of antibiotic resistance while there is still time.

According to a new report by the Ontario Medical Association, infections with antibiotic-resistant bacteria are becoming more frequent and difficult to treat

The Government of Ontario must develop a system for farm industry surveillance to keep track of the identities and quantities of antibiotics being purchased, and those being moved into or out of Ontario. Currently, surveillance of antibiotic movement does not exist in the province. Surveillance should be established in areas where it does not exist (agriculture) and strengthened in areas where it does exist (medicine) in order to collect data and gain a firmer understanding about antibiotic resistance in both humans and animals

any seniors in long-term care are given antibiotics for longer than likely needed, a new Canadian study suggests

Many seniors in long-term care are given antibiotics for longer than likely needed, a new Canadian study suggests

"High rates of institutional antibiotic use are driving increased rates of antibiotic resistance, Clostridium difficile infection, antibiotic-related adverse events and healthcare costs; yet up to half of antibiotic use in acute and long-term care institutions is unnecessary or inappropriate,"

Despite pumping $2.1 billion into home-care services to treat 637,000 clients last year, Ontario's system is clearly broken

. Combine that reality with an aging population that is being discharged from hospitals "sicker and quicker," and disaster awaits.

If Tenenbaum's experience - and numerous other horror stories - indicate the future, then aging or infirm Ontarians are in big trouble. On a more positive note, Premier Kathleen Wynne said in her throne speech that she "understands the pressing need" to expand home-care service.

She has warned the world faces an antibiotic apocalypse, a "ticking time bomb" and a "catastrophic threat to the population" as medicine faces the prospect of losing probably the most powerful weapon in its armoury - the effective antibiotic

Thanks to a combination of profligacy, wilful stupidity, the laziness of thousands of doctors and the selfish persistence of millions of patients in demanding instant cures for minor illnesses that would go away on their own, simple bacterial infections could once again become the scourge of humanity.

But in the past two decades, we've had a problem. No antibiotic, however potent, is ever completely effective. Like that disinfectant that "kills 99 per cent of germs," it is the one per cent that survive that you have to worry about.

The health coalition says that when there are major shifts in which service a hospital provides - such as doing less surgery, or transferring services to another agency - the LHIN's board must approve it. That hasn't happened, the coalition says. Neither has the 30-day period of public consultation that it says is mandatory. Nor is there public description of the changes to be made.

Mehra said opponents of the changes are not even able to protest adequately because the changes haven't been described publicly. Some jobs and patients may be shifted to hospitals as far off as Hawkesbury, or to clinics so small that they will create longer wait times, she said. "Yet the hospital has not made public, nor has the LHIN to our knowledge, a full list of impact upon services of these really profound cuts."

At the Champlain LHIN, chief executive Chantale Le-Clerc said the LHIN has been closely involved with the hospital's changes and is "comfortable" with them. There won't be a wholesale privatization, she insists. While the Riverside Hospital will stop offering the service, it will still be available at the Civic and General sites, she said - with some cases moving to existing private clinics. But she said patients, and their doctors, will choose where they go.

Ontario hospitals lag other provinces in six key clinical areas,

Ontario ranked slightly better than the national average in readmissions to hospital after knee replacements, in-hospital hip fractures for the elderly, obstetrical trauma during delivery and obstetrical readmission rates.

Provincial hospitals are reporting too many caesarean sections, too few vaginal births after C-sections, frequent readmissions for patients 19 years and younger, elevated readmission rates for surgical patients and a high number of medical and surgical patients who become more ill or injured while in acute care — a phenomenon captured in a category called “nursing-sensitive adverse events.”

Details emerged last month about the case of an 87-year-old Toronto woman who lost her life in December. This shocking incident raises difficult questions that need to be answered if a similar tragedy is to be avoided.

Worse still, paramedics would have reached the scene when she was still alive but were redirected no less than seven times to other emergencies considered to be more critical.

Emergency medical services throughout Canada are struggling to cope with the demands placed on them by an aging population. Because they so often find themselves alone, many elderly citizens often rely on paramedics for help when something goes wrong,

A rising workload means ambulances are not able to reach all emergency patients within provincial response times, Hastings-Quinte Emergency Medical Services Chief Doug Socha said, adding the only solution is more staff.

He said the service is stretched to "maximum capacity," and not only will some rural residents not get an ambulance during peak times, but Hastings County is paying thousands of dollars in overtime wages as well.

The "critical" problem isn't so much the current situation as the risk related to future calls, he said. Paramedics are busiest in the region's urban centres--and last year their response times actually improved.

etails of Ontario hospital contracts with consultants, cafeteria operators, cleaning staff or baby formula suppliers remain secret even though hospitals became subject to Freedom of Information Act provisions at the start of 2012.

But exemptions in the act protect hospitals' economic interests and their ability to be competitive, so private third-party contracts (funded by taxpayer dollars) remain inaccessible.

Advocates of public sector accountability say the secrecy surrounding those contracts must change. "Hospitals have privatized a range of services from food services to IT contracts to construction contracts," said Natalie Mehra, director of the Ontario Health Coalition, a public health care advocacy group. "In various areas there are claims that contracts have gone to friends of the CEO, to third parties that don't have an arm's-length relationship with the board or its executives. "The things we need to know are: how much money, to whom exactly, for what services and what are the terms they are getting for those deals."

As Canada's population ages, a growing number of frail seniors will require long-term care

This IRPP study examines which financing schemes are most likely to ensure universal coverage of long-term care services in an equitable and efficient way, and what should be the role of governments in that regard.

Private long-term-care insurance is, by its very nature, subject to significant market failure

“It is OK,” Matthews told reporters Monday. “There may well be beds closed but that’s not a bad thing because if you are getting people home and providing care for them at home then sometimes it’s appropriate to close a bed ... I don’t measure the success of our health care system by how many beds we have,”

Matthews said 17 per cent of acute-care beds are filled with patients who would be better served elsewhere, including long-term care,

Despite the rhetoric of the health minister and our new premier (Kathleen Wynne), these services are not being replaced in non-profit community and home care. They are being cut and privatized.”

Though Eastern Ontario hospitals are performing fewer cataract surgeries than they did last year - they've dropped from 11,400 to a projected 9,800 at The Ottawa Hospital, for example - Le-Clerc said wait times have increased only slightly. That's because the numbers in the past few years were inflated by extra spending designed to reduce wait times, she said. The provincial average is now 132 days, well below the government's 182-day target.

In Kingston, the Hotel Dieu Hospital used up its 2012-13 quota for cataract surgeries about two weeks ago.

t had been doing about 60 operations a week, but will now do only the most urgent cases - about 10 a week - until the new fiscal year begins April 1, said Mike McDonald, the hospital's chief of patient care. In the meantime, the hospital will receive no funding for the cataract surgeries it performs, he said.

Why do we not hear more about the lack of construction of new long-term care facilities or plans for them?

March 2010

Ten months later we were told by CCAC the wait would be eight to 12 months. In November 2012 we were told Mum is number 1,279 on the list but there are 1,842 persons ahead of her. We have never been called.

$31-million budget shortfall for 2013-14.

"They've been talking this up softly for a handful of months now,"

Premier-designate Kathleen Wynne said during a conference call Thursday the hospital cuts were part of a restructuring of the system to improve community-based access to health services.

Patients languishing on stretchers in hospital hallways, hospitals issuing capacity alerts when they can’t take more patients, tension in emergency departments as patients wait hours and even days to be admitted. That’s too often the reality in our hospitals

Canada has 1.7 acute care beds per 1,000 residents, which is only half of the average per capita rate of hospital beds among the 34 countries of the OECD.

The average occupancy rate for acute care beds in Canada in 2009 was 93%, the second highest in the OECD, surpassed only by Israel’s rate of 96%, according to OECD figures.

The private-sector contractor providing the meals at Royal Jubilee was scoring poorly on patient surveys.

But a new food system that gives patients a restaurant-style menu with dozens of options, along with cooking innovations to improve food quality, has turned around a system renowned for – to be blunt – wretched meals.

Today, the amount of food waste has shrunk by 38 per cent.

Public nursing homes should not be privatized, according to Niagara Region's internal cost watchdog.

The respons ive region improvement team reached that conclusion in its study of Niagara's long-term care homes, released this week. The report, headed for Monday's audit committee meeting, instead asks councillors to approve looking at consolidating a few older homes into big new buildings.

McQueen said the region's system is competitive with private nursing homes in everything but wages and benefits.

Both the college and Health Minister Deb Matthews say they want to change the bylaw under the Regulated Health Professions Act. Fair enough, but the loophole never should have existed in the first place, and it should be correctly immediately. It won't happen, however. Not with the legislature prorogued until sometime in the new year.

The situation becomes more urgent because the Liberals have been encouraging physicians to provide these services in clinic settings, and they've been only too happy to oblige.

"That's the direction that health care is clearly going," Windsor Regional Hospital CEO David Musyj said. "If that's the direction its going to go, you have to make sure the oversight of these out-of-hospital services is beefed up."

The massive scale of public-private partnerships - which can cost hundreds of millions of dollars - make the projects more of a magnet for greed, experts say in the wake of a corruption scandal involving construction giant SNC-Lavalin Group Inc.

"Since P3 contracts typically lump together designing, building, financing, maintaining, sometimes operating the facility, they tend to be honking big numbers because you're packaging so much together. To the extent that crooks are attracted to the really big-ticket items, it makes it that much more attractive as a target for misbehaviour," said Thomas Ross, director of the Phelps Centre for the Study of Government and Business at the University of British Columbia. "That's not saying it's P3, it's the size."

But there are measures that place P3s in a better position to protect against corruption. "Because there has been a lot of suspicion about P3s when we first started to do them, there was a big push for transparency," Prof. Ross said.