Sunday, November 29, 2009

Hospital budget cuts now "the right thing to do" in Ontario's Liberal health monopoly

This scenario is like deja-vu to St.Catharines residents: Kevin Swayze reported in "Cambridge hospital wants to cut 85 workers, but says care won’t suffer", (Waterloo Record, Nov.27, 2009, here):

"Cambridge Memorial Hospital must slash $11 million from its budget if it is ever going to see a penny of provincial money for a long-promised expansion, local health officials say.

“I would say it’s a prerequisite for getting approval of the project,” said Murray Martin, a provincial supervisor running the hospital since September.

He understands the province intends to announce the project in the spring.

If Cambridge Memorial’s books aren’t balanced — Cambridge was on track to run a $5.6 million deficit this year — Martin said there’s no way the province would approve a $39 million expansion promised more than a decade ago.

Martin’s budget-balancing plan includes cutting 85 jobs and closing 35 beds. It was approved Thursday night by the Waterloo Wellington Local Health Integration Network, the agency that distributes provincial health dollars across the district.

It will be presented at public meetings Friday at the Cambridge Hotel and Convention Centre, 700 Hespeler Rd., at 10 a.m., noon, 4:30 p.m. and 6:30 p.m.

Here’s the plan to balance the $100 million budget:

Eliminate 85 positions in the workforce of 1,300. Leaving vacant job positions unfilled has already trimmed 25 positions over the last few months. Martin hopes an early retirement plan and natural attrition over the next year will reduce the layoffs to almost none.

Close 32 beds for patients awaiting transfer to long-term care facilities. This will be offset by improvements in home care, shifting some patients to Freeport Health Care Village in Kitchener and expanded wards at St. Joseph’s Hospital in Guelph, and moving many into nursing home beds across the district.

• Merge the cancer and palliative-care wards, and the pediatrics ward and the nursery for newborns.

Move some outpatient programs, such as cardiac rehabilitation, to other providers in the community.

Make more use of registered practical nurses, who earn less than registered nurses.

Create a 10-bed, “short stay” surgical ward. Along with changing operating room schedules, this reduces the number of non-emergency surgery patients staying in hospital on weekends. That’s the equivalent of closing three beds in the budget.

These changes mean Cambridge Memorial will focus more on acute-care services, shedding outpatient services and beds for patients who should be in nursing homes or other facilities where the care is less expensive.
Click here to read a four-page summary of the hospital improvement plan.
Click here to read the full report.

Click here to view the presentation to the health network meeting Nov. 28.

Former Cambridge hospital board chair John Bell wasn’t impressed with how his hospital administration has been treated by the health network or the province. He quit in protest after Martin was appointed in September, prompted by a health network study that harshly criticized hospital management.

Bell, ousted hospital president Julia Dumanian and the hospital board proposed most of the cost-cutting ideas approved Thursday night, but they weren’t fully accepted in June by the health network, he said.

“It’s very disappointing to be back to the same place, that we had to put everybody through all this disruption. I think that’s all I should say.”

Sandra Hanmer, the health network’s chief executive officer, rejected Bell’s assertion.

“The plan that was presented was not the same plan,” Hanmer said.

“There may be some similar themes, but the hospital has gone through strong a risk management approach . . . it looked what services it provides and how to provide them.”

Dr. Mike Lawrie is a family doctor and the hospital’s interim chief of staff. He supports the plan but agreed it’s pretty much what was proposed in the summer.

“The plan has been tweaked and refined. Many of the basics were there,” Lawrie said. “It’s facing hard reality in a creative way.”

Cambridge Memorial’s workers are eager to offer cost-saving ideas while maintaining — and improving — patient care, Martin said. More than 200 ideas have been received; many have already been adopted to allow the hospital to face a freeze in provincial funding at the same time facing increased staff costs from union contracts and operating expenses.

Martin was adamant care will not suffer at Cambridge Memorial. In fact, he said the staff-inspired ideas will improve care throughout the hospital.

“I think the community should be very pleased with what the (hospital improvement plan) has accomplished,” Martin said.

Hospitals are late to the cost-saving, “lean-process’’ mindset that private industry long ago adopted to operate more efficiently, Martin said.

Staff offered more than 200 ideas since September that helped find $3 million in annual savings. These include work-schedule changes, smarter ways to offer care, and more efficient ordering of supplies.

“We’ve pretty well turned over every rock to see if there are opportunities in every area of the organization,” Martin said.

Hospital staff were given details of the final phase of the cost-cutting plan at meetings Wednesday and Thursday.

Sweeping as it is, the financial makeover at the hospital has been expected in the community. The plan calls for continuation of oncology outpatient care without service changes. The clinic was rumoured to be a casualty of the cuts.

A pain clinic won’t close. Instead, there’s an investigation into expanding it to handle more patients from outside the city.

Breastfeeding support services weren’t entirely eliminated. New moms in hospital will continue to receive coaching from nurses. Once discharged, moms can use services offered by the Waterloo Region health unit.

The hospital improvement plan is based on no increase in support from the province. About 85 per cent of the hospital’s budget comes from taxpayers. The rest is raised from fees to patients, insurance companies and visitors parking in the hospital’s lots.

Martin said the efficiency push must continue, even after the improvement plan is fully implemented a year from now.

“This is going to be part of everyday hospital life until we see a strong recovery in the economy,” Martin said. “We know with the economic reality. This is not a one-off event.”

Even if the province gives more operating money than expected, the restructuring will continue, he said.

“All of this should happen because it is the right thing to do.” "

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Please note that it was a McGuinty Liberal-appointed supervisor - Murray Martin - who said that hospital cuts were the "right thing to do".
Remember this, when Deb Matthews spews her Liberal health care duplicity that her Liberals have NOT cut health care!!!


Interesting to note that "If Cambridge Memorial’s books aren’t balanced — Cambridge was on track to run a $5.6 million deficit this year — Martin said there’s no way the province would approve a $39 million expansion promised more than a decade ago."


Maybe folks in Cambridge could examine why a similar tactic (see here; here) was tried in St.Catharines by Jim Bradley's and George Smitherman's Liberals, forcing hospital budget cuts and linking this to threats that future hospital plans could be jeopardized.
The St.Catharines hospital in the Niagara Health System was reported just in mid Oct. 2009 as having one of the highest deficits in Ontario - yet a new billion dollar hospital was not only approved, but is being built.

McGuinty's LHIN's are keeping entire communities in the dark, like proverbial mushrooms.
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Read the Apr.23, 2015 Globe story here to see how Jim Bradley's monopoly-enforcing fascist Liberals continue to choke Ontario's health system and cut hospital budgets. Betcha Michael Moore doesn't care.
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