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Govind Rao

Council of Canadians opposes "competitive bidding" for home care services in Nova Scotia | The Council of Canadians - 0 views

canadians.org/...home-care-services-nova-scotia

from heather NS ally home care privatization

shared by Govind Rao on 20 Apr 15 - No Cached
  • April 17, 2015
  • The Council of Canadians is opposed to "competitive bidding" for home care and support services in Nova Scotia. In an opinion piece published in the Chronicle Herald, Halifax-based Council of Canadians organizer Angela Giles and allies note, "Health and Wellness Minister Leo Glavine recently announced plans to seriously consider opening home care and support services to competitive bidding. This would allow private, for-profit corporations to bid on contracts currently provided by government and not-for-profit agencies. This competitive bidding process will award home-care contracts based on the lowest bid, not on who will provide the best quality of care. To date, Mr. Glavine has refused to hold consultations or allow for public input."
Irene Jansen

After all the months of debate, does the health bill actually stack up in law? | Left Foot Forward - 1 views

www.leftfootforward.org/...loucestershire-legal-challenge

nhs campaign social care bill trade competition

shared by Irene Jansen on 05 Apr 12 - No Cached
  • a test case campaign to challenge the establishment of a social enterprise – namely Gloucestershire Care Services Community Interest Company – has been fought and won by 76 year old Michael Lloyd, working with ‘a cross party coalition of anti-cuts campaigners’.
  • They argued the local PCT had acted unlawfully in planning to hand over management of nine county hospitals and 3,000 community health staff in what would have been the biggest planned transfer (so far) to a social enterprise in the country.
  • the Lansley edict of July 2011, that £1 billion of NHS services would be opened up to competition.
  • ...12 more annotations...
  • NHS Gloucestershire had not put this work out to tender, nor explored in-house/NHS options which, campaigners say, would have made tendering unnecessary in the first place
  • only reduced staff terms and conditions upon the service leaving the NHS, would offer a key cost saving
  • any cost gain would be significantly reduced by the new social enterprise VAT bill
  • which would not have applied under the internal NHS model
  • “The South West is leading the charge to social enterprise – with 15,000 of 25,000 staff in the UK, likely to be affected by reduced terms and conditions, coming from the region.”
  • Lansley’s ‘do it quick never mind the risk’ stick, the underbelly of which we highlighted last week
  • the Hull example, where aside from the one-off transfer costs, when NHS Hull morphed into a social enterprise, they found the need to build an entire new wing to house the extra administrative staff – those who had been ‘cut loose’ from the NHS – because the new enterprises are required to have their own duplicate back office functions where previously they could draw on NHS central resources.
  • as long as matters are kept within the NHS there is no contract on which EU procurement law ‘actually bites’,
  • this result at the High Court also begs the question: now the Bill is passed, exactly how far are our current NHS providers obliged to put existing services out to competitive tender?
  • The Gloucestershire example seems to demonstrate there are more angles to take than even the government themselves had considered in their own search for profiteering loopholes.
  • Will it really be possible, as Professor Allyson Pollock advises, to “stop all commercial contracts”, citing the danger of the government continuing to claim commercial confidentiality trumps the public’s right to know about contract decisions.
  • The PCT is legally obliged to: 1). Involve public; 2). Consider NHS options; 3). Invite ‘expressions of interest’ (in bidding) – crucially, not the same as ‘inviting bids’; before 4). Deciding what to do, which may or may not involve ‘inviting bids’, depending on whether NHS bodies come forward, which would mean they didn’t need to go to stage of open tender, i.e. inviting bids.
Govind Rao

Private home care would give seniors poorer, inefficient aid - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|hlch|20150418|218703802

from heather NS home care coalition cupe privatization cuts

shared by Govind Rao on 20 Apr 15 - No Cached
  • The Chronicle-Herald Sat Apr 18 2015
  • Health and Wellness Minister Leo Glavine recently announced plans to seriously consider opening home care and support services to competitive bidding. This would allow private, for-profit corporations to bid on contracts currently provided by government and not-for-profit agencies. This competitive bidding process will award home-care contracts based on the lowest bid, not on who will provide the best quality of care. To date, Mr. Glavine has refused to hold consultations or allow for public input. Seniors' care is too important to leave to partisan political interest. In response, the Nova Scotia Citizens' Health Care Network is hosting a series of town hall meetings across the province. The next three will be in Sydney on April 21, in Amherst on April 30, and in Halifax on May 4. Details can be found online at www.nshealthcoalition.ca. We are deeply concerned by this move. The wait list for home care in Nova Scotia has been rapidly expanding. Over a six-month period in 2014, the wait list increased by 80 per cent, from 422 to 760 patients needing care. With the oldest population in the country, and some of the highest rates of chronic illness, this trend is sure to continue.
Irene Jansen

Defending Public Healthcare: If contracting out works, why do they keep suspending it? Leftwords - 0 views

ochuleftwords.blogspot.ca/...ing-out-works-why-do-they.html

ontario home care competitive bidding

shared by Irene Jansen on 18 May 12 - No Cached
  • The Ontario government's system of contracting out for home care services (the so-called "competitive bidding" system) has been put on hold for another two years, it seems. 
  • Following a meeting with government officials, various bosses and mucky-mucks in the Ontario home care industry have come out and  declared the following:  
  • As proposed in a first step in a phased transition, new contracts would be developed and then negotiated with existing service providers outside of a competitive bidding process, effective October 1st, 2012 for the subsequent two year period (2014). These new contracts would reflect the realities of our environment; quality imperatives, fiscal restraint, greater focus on client-centred care and defined client populations, and the requirement to collaborate and implement change over a short period of time.   In subsequent phases it is proposed that all home care contracts will be renewed based on clear performance metrics related to transition, quality improvement, client satisfaction, innovation and value for money. Opportunities for new entrants to obtain contracts would be provided through joint ventures, subcontracts or other arrangements.
  • ...2 more annotations...
  • This is just the latest suspension of compulsory contracting.
  •  In the face of community opposition, the government has been forced to suspend the process for years.
Irene Jansen

TheSpec - Home care's 'race to the bottom' - 1 views

www.thespec.com/...home-care-s-race-to-the-bottom

home care on two tier wages union competitive bidding substitution integration

shared by Irene Jansen on 30 Apr 12 - No Cached
  • St. Joseph's Home Care is ready to compete for a flood of opportunity believed to be coming this fall when the province is expected to overhaul how contracts are awarded.
  • The home care agency — run by the same organization as St. Joseph's Hospital and Villa — cut wages by up to 15 per cent in all new contracts it wins.
  • The $13.96 starting hourly rate is now below Hamilton's living wage of $14.95. It takes five years to reach the top rate of $15.31.
  • ...9 more annotations...
  • That's also below the starting wage of $16.07 for personal support workers, dietary aides, health aides and home cleaners.
  • Kim Ciavarella, president of St. Joseph's Home Care. “We introduced this new tier so we'd be able to bid on those contracts. It positions us very nicely.”
  • The 190 workers came close to striking over the two-tier system that sees lower wages go to staff working on any new contracts
  • “We feel it's a race to the bottom,” said Bill Hulme, community care lead for the Service Employees International Union Local 1 Canada, which represents 10,000 home care workers including those at St. Joseph's.
  • The low wages, combined with a lack of job security, have made home care the most unstable sector of the health care system and the hardest in which to retain staff, says Jane Aronson, a home care researcher and director of McMaster's school of social work.
  • “I find it unfathomable that at the same time the provincial and federal governments keep saying home care is very important, it's organized so those who are its front line staff won't have security and in this instance won't even have a living wage,” she said. “It's not a field people can afford to work in very long so we lose people with skills.
  • home care workers make far less than the hourly wage because they're often not paid for their transportation time between clients
  • The province halted competitive bidding in January 2008 to try to resolve some of these issues. It's expected something new will be in place this fall.
  • St. Joseph's Health System is testing what it calls “bundled care,” which involves the province giving a set amount of money to provide diagnostic, hospital, long term care and home care to patients with a co-ordinator overseeing it all and acting as a point of contact.
Govind Rao

Home care competitive bidding invites for-profit companies | Halifax Media Co-op - 0 views

halifax.mediacoop.ca/...33519

from heather home care union coalition campaign NS

shared by Govind Rao on 06 May 15 - No Cached
  • Quality of care will suffer and workers will leave, Town Hall panel predicts
  • by Robert Devet
  • KJIPUKTUK, (HALIFAX) - Last night's town hall meeting in Halifax, organized by the Nova Scotia Health Care Coalition, tackled the privatization of home care.
  • ...1 more annotation...
  • In November of last year Leo Glavine, Minister of Health and Wellness, first talked about his intention to move to a competitive and profit-driven home care model. Currently home care services are mostly provided by nurses and home support workers employed by not-for-profit organizations such as the Victoria Order of Nurses (VON).
Govind Rao

CUPE concerned about latest development in home care | Canadian Union of Public Employees - 0 views

cupe.ca/t-latest-development-home-care

from heather cupe novascotia NS home care privatization

shared by Govind Rao on 29 Jun 15 - No Cached
  • Jun 10, 2015
  • HALIFAX – CUPE Nova Scotia is concerned about the memo “Exploring Home Care Options” from the Continuing Care Branch of the Health and Wellness Department that sends conflicting messages about the province’s plans to privatize home care. CUPE Home Support Coordinator Marianne Welsh says, “While the government appears to be back-tracking on its plans for so-called ‘competitive bidding,’ the idea still hasn’t been rejected outright.” “In fact,” says Welsh, “the memo which was sent to all home care agencies in the province makes it clear that the Department is reserving the option to privatize services. The memo states, ‘Depending on the outcome of this initiative, home care services may still need to be tendered for some, or all, regions in the province’,” says Welsh. CUPE represents 462 home support workers in the province and has called upon the government to reject the competitive bidding model for home care.
Irene Jansen

The Mowat Centre for Policy Innovation. A TRANSFORMATIVE BLUEPRINT FOR REDUCED COSTS, IMPROVED ACCESS AND QUALITY. October 31, 2011. - 0 views

www.mowatcentre.ca/press-releases.php

abf private clinics competitive bidding it

shared by Irene Jansen on 23 Jan 12 - No Cached
  • the Mowat Centre at the University of Toronto has released a blueprint for transformative changes to the healthcare system
  • The report recommends five significant changes: • Modernize the organization of hospitals, with academic centres focused on diagnostic work-ups, specialty clinics providing routine procedures efficiently and accessibly, and networks of care that monitor patient well-being • Embrace the ‘‘virtualization’ of many existing services that are currently only delivered in person • Widely deploy digitization by reforming agencies so that they can respond to technological change more quickly and by providing more IT funding directly to providers • Encourage organic governance evolution without undertaking wholesale restructuring, and • Reform the way health services are purchased.
  • The report is part of the Shifting Gears Series on the transformation of public services and was supported financially by KPMG.
  • ...1 more annotation...
  • To read the full report, please click here
  • Irene Jansen on 23 Jan 12
     
    National Post coverage: Innovations seen as lowering health costs. National Post. Nov 1 2011 Tom Blackwell  Provinces must find ways to profit from efficiencies - like the steadily falling cost of cataract surgery. While favouring marketstyle competition, the academics draw the line at allowing a private tier of medicine or even expanding the role of privatehealth operators in the public system. Set up more stand-alone clinics, like those that do cataract surgeries. Move away from block funding of hospitals (an institution is paid a lump sum every year to cover most services) toward payments tied to treatment of individual patients. Cap increases in physicians' fees, link fees more closely to changes in technology and hold auctions in the public system, to get the best deal for providing some procedures. Experience suggests doctors may not welcome some of their proposals. In 2002, a $4-million study funded by the Ontario government - and initially supported by the Ontario Medical Association - recommended an overhaul of the fee schedule to better reflect the up-to-date value of each doctor service. It would have meant income drops for some specialists - such as the opthalmologists who do cataracts - while others would earn more. See also: Health Care reform? Despite frightful predictions of ever-rising costs, governments can reap savings by managing change Toronto Star Nov 1 2011  Opinion  Will Falk
Heather Farrow

Loblaw bids for health records provider - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246200|ntnp|20160823|254460258

privatization it technology

shared by Heather Farrow on 23 Aug 16 - No Cached
  • National Post Tue Aug 23 2016
  • Loblaw Cos. Ltd. is planning to expand its growing presence in the health care industry, proposing a $170 million, all-cash friendly bid to buy a B.C.-based company that develops electronic medical record technology. The country's largest food retailer offered $3.10 cash per share for Kelowna-based QHR Corp. - or 22 per cent over the stock's price on the TSX Venture Exchange at Friday's close - saying it will be a "natural complement" to its Shoppers Drug Mart division. Loblaw purchased Shoppers, Canada's largest retail network of pharmacies, in 2014 for $12.4 billion. A shareholder vote on the QHR deal will require two-thirds approval, and is expected to take place at a QHR special shareholder meeting in October. It already has the approval of QHR's board of directors.
  • QHR chief executive Mike Checkley said exclusive negotiations began two weeks ago following an unsolicited offer from Loblaw. "We weren't out to sell the company," he said on an investor conference call. "What came across the table we felt was very fair and we feel this is absolutely the right arrangement for us and our customers." The deal does allow QHR to consider other offers, and comes with a $6-million break fee if one is accepted. If approved, the acquisition would give Loblaw a foothold with the 7,700 health care providers QHR currently supports with its suite of electronic medical records technology - that business accounts for 20 per cent of the Canadian electronic health record market, which is worth approximately $350 million per year, according to Cantor Fitzgerald analyst Ralph Garcea.
  • ...3 more annotations...
  • We recognize that the future of health care is digital and this strategic investment will make us a better health and wellness partner to patients and providers," said Loblaw spokesperson Tammy Smitham. "QHR brings complementary talent and technology to our organization, providing opportunities to establish new business partnerships and drive improved care co-ordination for Canadians." Smitham said that Loblaw has no short-term plans to change the way its pharmacy business operates - but that the company is hopeful the acquisition will in the long term make its patient care more efficient, and allow it to work with more health care providers beyond the pharmacy niche. In recent years, retailers including Shoppers have added medical services, notably dispensing flu shots and prescription renewal services, as governments have sought to regulate the professional allowances pharmacies receive from drugmakers. RBC Dominion Securities analyst Irene Nattel said in a note that the QHR acquisition will have negligible impact on Loblaw's results but should fit alongside the company's existing pharmacy and health care operations.
  • QHR's shares climbed 22 per cent to close at $3.10 on the TSX Venture Exchange Monday. Loblaw shares were up one per cent, closing at $71.81 in Toronto. Loblaw has looked to its Shoppers division to deliver new avenues for earnings growth, as competition for sales volume in its grocery business has expanded beyond traditional competitors like Metro Inc. and Sobey's to include big-box retailers Costco Wholesale Corp. and Walmart Canada.
  • The Shoppers acquisition in 2014 gave Loblaw access to smaller sized stores in high-density urban neighbourhoods. Following the introduction of increased food and grocery offerings at its drugstores, revenue growth at Shoppers Drug Mart outpaced other parts of the company's business in the second quarter.
Irene Jansen

Don't try this at home! Lessons from England of what not to do to your health care system | Global Health Check - 1 views

www.globalhealthcheck.org/?p=579

nhs privatization

shared by Irene Jansen on 31 Jan 12 - No Cached
  • the National Health Service, which for decades had management overhead costs of 5%
  • The additional costs of this market split in England have increased overheads to over 14% of NHS spending – an extra  £10 billion per year .
  •  In England Independent Sector Treatment Centres set up by Labour to create a new private sector provider network, charge an average 11.2% above the standard NHS cost. But they cherry-picked only the easiest cases  – leaving the rest to the NHS. And they were given generous 5-year contracts, which paid them for a fixed number of operations, regardless of how few patients chose to use the service.
  • ...6 more annotations...
  • The first Foundations were set up from the wealthiest, most successful hospitals, and have accumulated surpluses of £2 billion – while NHS hospitals which are not foundations face mounting financial problems. Now ministers want to let them make unlimited money from private medicine, while funding for NHS patients is being sharply reduced.
  • the damage done to hospital cleaning standards by Margaret Thatcher’s government putting cleaning and other support services out to tender in the 1980s
  • Two decades later hospitals are still struggling with the rising tide of infections and hygiene problems caused.
  • 100 hospitals have been built since 1997 using the “private finance initiative”
  • Some early PFI hospitals have already paid back double the cost of the hospitals, but still have 15-20 years to pay. Many PFI hospitals are closing beds and wards in the new hospitals and sacking staff to cut costs: some need rescuing by government.
  • Now services in the English NHS could be opened up by the new government to competitive bids by “any qualified provider”. But the private sector will only bid for services where it is certain of a profit.
Govind Rao

P3 secrecy disrespectful to taxpayers - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|sasp|20151024|232099804

from heather p3 privatization Saskatchewan

shared by Govind Rao on 26 Oct 15 - No Cached
  • The StarPhoenix (Saskatoon) Sat Oct 24 2015
  • As Premier Brad Wall's Saskatchewan Party government heads toward an election in April, it has clearly recognized the need to mind its P's and Q's. So one can only wonder why it's not better at minding its P3s. Its justifications for its public-private partnership approach - especially when applied to the now $1.8-billion-plus Regina bypass - are becoming more specious by the day.
  • In fact, the government is in full spin mode, providing the media and even the NDP Opposition with Highways Ministry technical briefings. The problem, however, is the more information it releases in dribs and drabs, the more legitimate appear the questions it seems to be providing for the media, Opposition and the "Why Tower Road?" crowd, which is now running a TV blitz on the costs. This week, the questions seemed a lot better than the answers.
  • ...10 more annotations...
  • It all started with Opposition critic Trent Wotherspoon, who questioned the logic of government-employed snowplow operators plowing the Trans-Canada Highway having to lift their blades as they approach the 20-kilometre stretch of bypass from Balgonie to Regina.
  • This is what will happen once the bypass opens in 2018, because all maintenance matters (plowing, grass cutting, pothole and structural repairs, etc.) for 30 years will be the responsibility of the successful bidder - a Paris-based conglomerate. It will hire Saskatchewan crews to do the work. Highways Minister Nancy Heppner was especially indignant, scolding Wotherspoon for not asking enough questions at his technical briefing and thus again bringing information to the assembly "that is not always correct."
  • The problem, however, is Wotherspoon does appear to be correct. And the Highways Ministry explanation as to why this would be the case was something-lessthan gracious. "So what?" ministry spokesman Doug Wakabayashi told the Leader-Post's Emma Graney, adding he failed to see why this was even an issue because it wasn't like "nobody's plowing" the bypass.
  • Of course the bypass will get plowed. No one is being so disrespectful as to assume the minister or her departmental officials don't understand their rudimentary maintenance responsibilities ... even if the politicians and their officials seem to have little interest in exchanging the same courtesies.
  • The question is how much more this approach might cost Saskatchewan taxpayers. It seems it will be substantially more expensive than using government crews ... although no one seems to know how much more. Notwithstanding the government spin-session briefings, that's one of the many things about the P3 bypass project ministers are not telling us. The maintenance costs are a portion of an extra $680 million (essentially, the difference between the previous bypass construction estimate of $1.2 billion and the current $1.8-billion-plus price tag) that is called "risk transfer."
  • But how much of that extra $680 million taxpayers will shell out during the next 30 years for maintenance of the measly 20-kilometre stretch of highway remains an unknown. What we do know is that the snowplowing budget for the whole province is only $29 million a year. Under the rules of the P3 bidding process, such a detailed breakdown in the bypass contract can't be released for competitive reasons, said SaskBuilds president Rupen Pandya.
  • But why, then, is the global cost of "risk transfer" so high? Well, risk transfer in P3 contracts is what the government considers to be the cost of replacing or restoring something to brand-new condition. Some in the know don't much like the concept.
  • Ontario provincial auditor Bonnie Lysak (who used to be Saskatchewan's auditor) criticized the use of risk management in her assessment of Ontario P3s. She concluded risk transfer didn't apply to any accounting reality. After all, it's not likely a school or hospital will have to be replaced because it was swept away by a tornado. It's even less likely this will happen to a bypass.
  • But it is a good way for a government to hide cost overruns and thus prove its philosophical case that P3s are less expensive than the traditional method of private companies bidding and then building an infrastructure project without taking any long-term ownership of it. By the same token it would also be a very good way of government claiming that a P3 project came in under budget if there were no cost overruns, or only modest ones.
  • "Risk transfer" may not have ever been a real cost in the P3 process - something the government might not be eager to tell you in a technical briefing. Maybe one day we will get answers. But one guesses the Sask. Party government won't be offering them before the April election.
Govind Rao

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

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

from heather home care employer bankruptcy

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

There are hidden costs of moving care out of hospitals. Jeremy Petch and Danielle Martin. healthydebate - 4 views

healthydebate.ca/...f-moving-care-out-of-hospitals

Ontario home care substitution

shared by Irene Jansen on 21 Feb 13 - No Cached
  • Providing care in the home also raises hopes of substantial cost savings for the government
  • If done well, moving care out of hospitals could improve patient care, while reducing health care spending. However, there are hidden costs, both financial and human, of moving care into the home that have received little public attention, including lower wages, riskier work environments and greater burdens on family caregivers.
  • A major source of expected savings from a shift to home care is lower wages
  • ...14 more annotations...
  • Personal support workers in the home care sector can be paid as little as $12.50/hour compared to hourly rates of $18 to $23 for their hospital-based colleagues.
  • Similar disparities have also been observed for other care workers, including registered nurses.
  • In addition, home care workers often do not get steady hours
  • According to Stella Yeadon, a representative for the Canadian Union of Public Employees, this is largely because union organizing is very challenging in the home care sector. Unlike the hospital environment where workers are in a single building, home care workers rarely meet one another.
  • support for family caregivers was notably absent from both Ontario’s Action Plan for Healthcare and the year-one update released last month. Support for caregivers is part of Ontario’s new Seniors Strategy, but it remains to be seen how much of this strategy will translate into action.
  • turnover as workers leave home care for higher paying jobs at hospitals is bad for patients
  • Low wages and limited benefits across an entire sector raise concerns about the possibility of recruiting skilled care workers. “
  • low wages could pose real barriers to recruiting and retaining staff.
  • Health care workers face substantial health risks as part of their work, due to their exposure to infectious diseases, violence from patients/residents with dementia, allergic reactions from chemical agents, and injuries resulting from lifting patients.
  • There is currently limited data on the occupational health risks of delivering care in the home. However, some care may be riskier in the home, where workers are more likely to be without either backup from other staff or mechanical assistance (such as patient lifts), as compared to workers in a hospital or a long-term care facility.
  • According to a report from the Ontario Health Coalition, another contributor to lower wages is the Ontario government’s procurement policy for Community Care Access Centres (CCAC), which requires CCACs to contract out home care services. While competitive bidding for contracts has been somewhat successful in keeping costs down for CCACs, it has done so largely by “driving down wages,”
  • patients who need home care do not have families to care for them
  • there’s no one to care for them but me and they need more help.”
  • lower wages and riskier environments raise the possibility that the quality of care may be negatively affected as services are moved from hospital to community settings.
Heather Farrow

Hospital contracts went to firms with family ties to executives, audit reveals - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20160817|254020940

hospital corporation fraud Ontario

shared by Heather Farrow on 17 Aug 16 - No Cached
  • The Globe and Mail Wed Aug 17 2016
  • A Toronto hospital awarded the family business of its former chief executive, Vas Georgiou, $223,000 in renovation contracts after his departure. Almost all of those invoices were approved by St. Joseph's Health Centre's thendirector of redevelopment, Suman Bahl - whose husband was a subcontractor on a third of those renovation jobs.
  • These findings - which are detailed in a report from auditing firm Deloitte - are the latest developments in a year-long Globe and Mail investigation into hospital executives and lucrative construction contracts, an investigation that has ensnared three Toronto-area hospitals, and triggered four independent probes as well as the departures of some high-profile executives - Mr. Georgiou and Ms. Bahl among them. At the centre of the story is Mr. Georgiou, who for decades has moved through senior positions at half a dozen Ontario hospitals, including St. Joseph's, where he was vice-president and later interim CEO.
  • ...9 more annotations...
  • After leaving that hospital in July, 2005, Mr. Georgiou took a top position with the province's procurement agency, Infrastructure Ontario. But outside of his day job, the former executive began working for a private family construction business, Toronto Engineering Company (TECO). By March, 2006 - and until December, 2007 - TECO was working for St. Joseph's hospital. During this period, Mr. Georgiou became involved in a scheme to defraud York University with bogus construction invoices.
  • Mr. Georgiou used two family businesses, including TECO, to invoice the university for $64,800 worth of renovation work he acknowledges his company never performed. (Mr. Georgiou was not charged criminally and reached a settlement with the university.) When The Globe presented evidence to St. Joseph's last September that the hospital had also done business with TECO, the health centre hired Deloitte to investigate. The firm completed its probe this past spring. Deloitte found that over the course of nearly two years, St. Joseph's Health Centre processed 18 TECO invoices worth about $223,000 for repairs, painting and project management. The report shows Ms. Bahl approved all but five. (The hospital's thenproject manager of redevelopment, Doug Wilson, signed off on the rest.)
  • Deloitte found no evidence that Mr. Georgiou declared his TECO ties to the hospital, although internal hospital e-mails suggest Ms. Bahl was aware of his connection, the review states. Through their lawyers, Mr. Georgiou and Ms. Bahl criticized the fairness of the reviews. The report was not a full-blown audit and drew no conclusions. Deloitte did not interview Mr. Georgiou, Ms. Bahl or any other former hospital employees or vendors.
  • In a letter to The Globe, Mr. Georgiou's lawyer, Gavin Tighe, said TECO's dealings with St. Joseph's began after Mr. Georgiou left, so there was no conflict, but that, regardless, his client disclosed those ties. "TECO competitively bid on work at St. Joseph's Health Centre," Mr. Tighe wrote, adding that "TECO did not at any time contract or pay BJ Quality Flooring or Darwin Fisher Flooring to perform work." Deloitte also determined that there "may also have been an attempt to conceal" the involvement of Ms. Bahl's husband in the renovation projects.
  • Travis Walker, a lawyer representing Ms. Bahl, wrote to The Globe that Ms. Bahl "denies any impropriety" and that "any potential conflict of interest was disclosed to senior management" and "no concerns were ever raised." It is not clear exactly what policies Mr. Georgiou and Ms. Bahl may have violated, because St. Joseph's has refused to comment on the rules it had in 2007. A hospital spokesperson said "gaps in the procurement process at the time are historical and have since been mitigated" and that Deloitte unearthed "no substantive findings that indicate any further exploration is required." St. Joseph's would not answer questions on the report. When Mr. Georgiou left St. Joseph's Health Centre, he was one of the most powerful and connected members of the hospital, having served as vice-president for five years and interim CEO for 10 months.
  • About a month before he began working for Infrastructure Ontario in January, 2006, Mr. Georgiou's family members registered TECO in Ontario. Mr. Georgiou's wife, Helen Saoulli, and her parents were listed as directors. Mr. Georgiou acted as a project manager for TECO, according to a statement he made during the York investigation. Over the next two years, TECO invoiced St. Joseph's for work that included installing a new security gate for the emergency department, wall patching and painting, and disposal of chemical waste, documents obtained through a Freedom of Information request show. BJ Quality Flooring, the company owned by Ms. Bahl's husband, Bojidar Danef, was listed as a subcontractor on seven of the quotes, the Deloitte review found.
  • The auditing firm noted there may have been an attempt to conceal Mr. Danef's involvement because, at some point in the process, BJ Quality Flooring was changed to "Darwin and Fisher" [sic] - except that the contact name, telephone number and price stayed the same. Doug McDonald, owner of Darwin Fisher, a commercial flooring company in Mississauga, says his company has never done business with TECO and he has no idea why TECO invoices would include it. Mr. McDonald noted that during that period, Darwin was doing extensive work for St. Joseph's, and that on some occasions, he hired Mr. Danef as a subcontractor. Last November, Mr. Georgiou's employment as vice-president of St. Michael's Hospital was terminated after The Globe revealed his involvement in the York fraud, and later the fact that he had private business ties to the president of a construction company that won a $300-million contract with the hospital that Mr. Georgiou had overseen and helped award. After those stories were published, Markham Stouffville Hospital - where Ms. Bahl was then a senior executive overseeing a redevelopment project - launched an internal probe when a whistleblower came forward with concerns. The findings brought a wave of departures, including those of Ms. Bahl and Mr. Wilson, who had left St. Joseph's and was working with Ms. Bahl in Markham. Mr. Wilson could not be reached for comment.
  • The Markham Stouffville review, which Deloitte also conducted, found that Ms. Bahl hired five of the hospital's contractors to renovate her 6,480-square-foot home, received favourable pricing from some and awarded renovation contracts at Markham Stouffville to her husband's flooring company and her late uncle's window-covering business. It appears Ms. Bahl also mixed her professional connections with her personal life when she was at St. Joseph's hospital. Deloitte found evidence that one of the hospital's furniture vendors "assisted Ms. Bahl in procuring office furniture for her home at a 50-per-cent discount from the list price," the report said. In another instance, Deloitte noted Ms. Bahl may have tried to circumvent hospital procurement policy by counselling an art supplier to invoice through a company that was already doing work for the hospital, rather than submit a payment request directly.
  • "This is the only way I can cover the cost," Ms. Bahl wrote to the art supplier in an e-mail obtained by Deloitte.
Govind Rao

Letters to the Editor Column - Infomart - 0 views

www.fpinfomart.ca/...185065146

from heather Ontario home care strike union

shared by Govind Rao on 18 Dec 13 - No Cached
  • The Timmins Daily Press Wed Dec 18 2013
  • STRIKE HITS CLOSE TO HOME It's a very sad day when those charged with looking after the elderly and the disabled in our communities can't count on decent wages and benefits. Now, I'm not blaming the Red Cross Care Partners (RCCP) because I believe they are doing the best they can given what the government has done to home care services in this province. Home care in Ontario was opened to "competitive bidding" over the last number of years with disastrous consequences. There are now more than 1,000 agencies delivering home care services in the province, and there are four levels of administration before any funds actually get into the hands of the front line Personal Support Worker (PSW).
  • A unionized Red Cross PSW receives maximum pay of $15.02/hr, but only after three years on the job while a non-union PSW gets paid between $12.25 and $13.50/ hr. PSWs working in a nursing home get paid an average of just over $20/hr yet they all must have the same level of education. To top that off, time spent driving to or between clients is not paid and the distances can be quite significant for RCCP caregivers in the north. Mileage is only paid if travelling between clients. If you live in Iroquois Falls and your only client that day happens to be in Ramore, you won't get paid any mileage at all! Health care benefits are quite poor and can be lost if the worker fails to work the minimum 1,352 hours in any given year. Red Cross PSWs do not have a pension plan and most only work part time. Many people have accepted the myth that we had been over taxed for way too long and the "tax relief" we now enjoy has made us all the more prosperous.
  • ...2 more annotations...
  • This is not the workers' fault.
  • BEN LEFEBVRE CHAIRPERSON NORTHEASTERN ONTARIO HEALTH COALITION
Govind Rao

'The health-care system in general is a mess' - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|cbpo|20150626|223600398

from heather NL cupe cuts privatization

shared by Govind Rao on 29 Jun 15 - No Cached
  • Cape Breton Post Fri Jun 26 2015
  • Plummer Avenue served as a line drawn in the sand on Thursday. One side of the street was a sea of red as Liberal supporters gathered at a barbeque to celebrate the opening of Cape Breton Centre Liberal candidate Dave Wilton's office, while the other side was a flurry of red and pink union flags and chants, as members of various locals and home-care workers were waiting for the expected arrival of Premier Stephen McNeil, protesting possible privatization of homecare. "We're here out of concern the Liberal government is gong to privatize all or some parts of home-care services," said Shauna McKenzie, of New Waterford, a home-care worker for 20 years.
  • "It would be a loss for the workers, we'd be concerned about their wages, pensions and health benefits if certain parts of homecare or homecare itself, are privatized." "We're trying to make the public aware, protest to the Liberals so they might not go this route." About 25 people were gathered at the protest, filling the air with chants of "hey hey ho ho, Stephen McNeil's got to go." Evelyn Doucette, president of Canadian Union of Public Employees Local 3986, said they were there because Premier McNeil was due there to help Wilton open his office.
  • ...4 more annotations...
  • "Were putting out a message to Stephen about the privatization that is going on with home support today, that we're against it," she said. "The plan being put out by the McNeil government to privatize homecare should be raising alarm bells for Nova Scotians. He has a lot of questions he should be answering. The health-care system is a mess." Doucette said although the province is saying right now they are no longer looking at competitive bidding for homecare, they're still saying home-care services might still need to be tendered for some or all regions in the province. "We still don't know where we stand with any of this, we need answers."
  • Roberta Hickman, of Glace Bay, a home-care worker for 18 years, expressed concerns privatization of homecare would mean the hiring of lower cost workers to do their duties. "We are concerned about the quality of care that's going to be delivered," she said. Hickman said clients are worried too, so the home-care workers are trying to play it down, not wanting to upset them.
  • "They have enough issues of their own, we don't want to add to it. We're just trying to deliver the best homecare we can." Premier McNeil did not show up for the noon to 1 p.m. opening, but it was discovered later he was at the office for a tour earlier that morning and had also stopped by the New Waterford Homecare Service Society office. Tony Kiritsis, media relations advisor for the Nova Scotia Department of Health and Wellness, said no decisions have been made in regard to homecare in the province, but the department is considering all options that will help improve the home-care system.
  • "We are not privatizing homecare. The main goal we are pursuing is to ensure that we have quality homecare services that put patients first. " Kiritsis said in the coming days the department will reach out to begin a discussion with Nova Scotians about the future of the home-care system and what people expect. "This will help government move forward with a plan to improve home-care service delivery in the province." smontgomery@cbpost.com
Govind Rao

Nova Scotia's home support services not for sale | Canadian Union of Public Employees - 0 views

cupe.ca/home-support-services-not-sale

from heather home care NS cupe

shared by Govind Rao on 12 Mar 15 - No Cached
  • TRURO – CUPE Nova Scotia President Danny Cavanagh says any plan by the McNeil Government to consider privatizing home support (home care) services should raise alarm bells for Nova Scotians. The province has issued a Request for Proposals (RFP) to develop a compulsory competitive bidding system for home support that appears to be fashioned after a failed model in Ontario. Most home support services in Nova Scotia are currently provided by non-profit agencies which have highly-qualified staff. These are Continuing Care Assistants, or CCAs.
  • Govind Rao on 12 Mar 15
     
    March 11 2015
Govind Rao

Let's get behind pharmacare; National pharmacare plan could save $7.3B, March 17 - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|tost|20150322|216924212

from heather pharmacare drugs

shared by Govind Rao on 23 Mar 15 - No Cached
  • Toronto Star Sun Mar 22 2015
  • It's heartening to see national media coverage of the most recent (peer reviewed) study on universal public coverage of prescription drugs in Canada. About 3.5 million people in Canada do not have their prescriptions filled due to financial reasons. Until we solve this problem, the promise of medicare remains unfulfilled. Here are some suggestions that might help to move the discussion forward. (a) Develop a national formulary that lists those drugs that are supplied as benefits to Canadians. (b) Institute drug coverage for all. Replace the present patchwork of drug coverage across the country. (c) Establish a Canadian drug benefit agency with authority to establish and carry out a national pharmacare plan.
  • (d) Negotiate drug prices based on a competitive bidding process using the power of a plan for 35 million people. (e) Ensure a rigorous drug assessment process for inclusion in the formulary. (f) Enlist the co-operation of prescribers and pharmacists to enhance prudent prescribing and drug use monitoring. (g) Debate and put to rest the argument that such a plan is too costly and has too many jurisdictional challenges. (h) Encourage dialogue among federal, provincial and territorial leaders and strengthen political will to address this serious gap in our health-care system. Bill Wensley, Cobourg
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