SEPP Organization Blog

Can Canada afford to be healthy? Karen Howlett Globe and Mail Friday, Feb. 26, 2010

Dr. Paul Dobrovolskis had just come back from vacation to his job in the emergency room when an official at the Greater Niagara General Hospital called with an ultimatum: Either go along with a new work schedule or leave. “That was the final straw,” Dr. Dobrovolskis recalls. He decided he would go, he declared that, because of constant cuts to its budget, the hospital where he had spent 14 years was “dying a slow death.” Three of his colleagues followed suit, leaving just two-full-time doctors on the emergency ward’s staff. Doctors voted non-confidence in its leadership, residents protested in front of the Ontario Legislature.

…Hospitals are cutting services and undermining their role as providers. “Our population here is older and sicker, and we have a national shortage of doctors and nurses.”

…Overall spending last year amounts to $5,452 for every Canadian, and roughly 12 per cent of the gross domestic product – an all-time high and almost twice the 7 per cent seen in the 1970s.

….governments at all levels seem determined to avoid a public debate on how to sustain a system many Canadians appear to take for granted.

…Parliamentary Budget Officer Kevin Page warns that the country must cut spending or raise taxes.

…Alberta retreated on plans to close acute-care and rehabilitation beds at an Edmonton hospital.

…British Columbia is trying to cut $160-million from budgets for its 12 hospitals, close a six-bed psychiatry unit, 10 beds for addiction-treatment.

…In Ontario, the government has quietly topped up funding for several cash-strapped hospitals.

…Niagara Health received another $14-million, all but erasing its deficit. With a shortfall expected to reach $24.7-billion this year, Ontario has launched the biggest restructuring of hospitals since the mid-1990s cuts.

…The gap between “what the public wants and what governments feel they’re in a position to give” is widening.

…Bureaucrats insist that changes they are making are all about improving the care the public receives as medicine becomes more sophisticated and highly specialized. But that’s a tough sell when cutting costs is the real goal.

…Niagara Health’s experience shows how trying to save by streamlining services can have unexpected consequences, leading to a disgruntled work force and, in some cases, even greater expense.

….In late 2008, converting emergency rooms into around-the-clock urgent-care centres, closing beds for patients with chronic illnesses saved $28milion.

…In the 1990s, Harris government’s Health Services Restructuring Commission oversaw the biggest shutdown of hospitals in Canadian history. It closed or merged 35 facilities.

…Converting the emergency rooms has failed. Niagara Health will save more than $1-million, but area municipalities and the province will spend an additional $3.1-million on ambulance service.

…Niagara Health announced that the medical staff faced a risk of “burnout” because they were seeing too many patients.

…“It is impossible for physicians to deliver appropriate care with time constraints.”

…Ontario Medical Association’s emergency medicine section said a shortage of beds was the real issue.

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