Thought of the Day – are there really cuts to health care or are the unions, public service and/or special interest groups misleading the people of Ontario?
For the past few months some members of the public service, many unions and special interest groups have been decrying purported cuts to the Ontario Health Care system.1These groups may not have reason to be protesting.
Liberal government(s) had been restraining, (another word for “cuts”) for nearly a decade
It seems the previous Liberal government(s) had been restraining, (another word for “cuts”) for nearly a decade and yet there seemed to be very little protesting during this time span. It would seem the unions, some health care sector employees and special interest groups are making this partisan instead of looking at the facts and perhaps one needs to read through the FAO’s report to see the reality – and put a stop the unions, public service and special interest groups protests…after all perhaps they protest too much, wouldn’t one think?
From the Financial Accountability Officer, 2018 report “Ontario Health Sector, An Update Assessment of Ontario Health Spending”:
“Since 2012, the Province has restrained the growth of health sector spending primarily by: imposing a four-year freeze in base operating funding to hospitals, increasing hospital efficiency, and restraining wage growth in the health sector.
"Going forward, it is not clear to what extent the Province can continue to rely on temporary measures, such as wage restraint, to limit health sector spending growth to below the growth in its core cost drivers.”2
Just this past month Minister of Health, Christine Elliott had announced increase funding for “small and medium-sized hospitals across the province … to help address deficits and other funding challenges.”3 And it would seem this isn’t the only area where the PC government has increased spending on health care.
But shouldn’t we look at the facts, instead? Yes, the PC government is amending the way health care is going to be provided. Yes, there are going to be employees removed – some refer to these as inefficiencies because they merely promote an even larger bureaucracy.
For this one merely has to look at the LHIN’s bureaucracy. This includes expanding their mandate into areas where they do not have authority to trespass – i.e. funding labs, nurse clinics which can cause infections in open wounds, decreased information to the patient/caregivers and one merely has to read the Auditor General’s reports to see the waste under this regime.
According to the Auditor General’s report from 2015, 90% of patients, who were referred to CCACs (Community care access4) by their family or primary-care physician, received their first CCAC in-home service in 28 days (as opposed to being referred by a hospital after a hospital stay)?5
LHINs wait time for CCAC in-home services (days) - Worst 82 days, Best 12 days depending on the LHINs.
In 2015 the expenditures for the Ontario Health System was approx.., $50 Billion of which the LHINs administered about half, or around $25 Billion, and the Ministry of Health administered the other half.
So how does this break down? Firstly, the LHINs do not provide health services – all health care providers, such as hospitals and long-term-care homes, still maintain their own boards of directors 6 and are still administered under the Ministry.7
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In 2015 the break down was:
Hospitals (156) -- $16.9 Billion
Long-Term-Care Homes (631) -- $3.5 Billion
Community Care Access Centres (14) -- $2.5 Billion
Mental Health and Addiction Centres (400) -- $936 Million
Community Support Service Agencies (584) -- $834 Million
Community Health Centres (76) -- $378 Million
And the Ministry's break down, which the Ministry's $25 Billion is spent:
Working relationships with LHINs managed by the Ministry
Primary Care
Family Health Teams
Independent Health Facilities
Provincial Health Agencies (duplicates of LHINs)
Cancer Care Ontario8
eHealth Ontario
Health Quality Ontario9
Public Health Ontario10
So, are there really cuts to health care or are the unions, public service and/or special interest groups misleading the people of Ontario?
**Note – in 2017 CCAC was transferred over to the administration of the LHINs by the Ontario Liberals.
Across Ontario, 90% of the patients who were referred to CCACs by their family or primary-care physician (as opposed to being referred by a hospital after a hospital stay) received their first CCAC in-home service in 28 days. However, depending on where a person lives in the province, the wait time could be as short as 12 days to as long as 82 days, a difference of more than two months. LHINs—Local Health Integration Networks, Auditor General Report 2015 section 3.08, p. 323 (17 of 56).
In moving toward a regional model, Ontario took a somewhat different path than that of some other provinces. The most significant difference between the LHIN model in Ontario and the regional health systems in other parts of Canada is that, in Ontario, LHINs neither directly govern nor provide health services: all of the health-care providers, such as hospitals and long-term-care homes, still maintain their own boards of directors. In contrast, in Alberta and Manitoba where all or most of the local boards of the individual health-care providers were dissolved, the regional health authorities themselves directly employ health-care workers, and directly provide health services, sometimes including primary care. LHINs—Local Health Integration Networks, Auditor General Report 2015 section 3.08, p. 307-308 (1-2 of 56)
See attached graph.
it is Cancer Care Ontario, a provincial government agency, that is primarily responsible for planning and allocating resources for cancer surgery and works with health service providers in every LHIN to improve cancer care for the people they serve. LHINs—Local Health Integration Networks, Auditor General Report 2015 section 3.08, p. 327 (21 of 56).
The Ministry accepts this recommendation and is implementing strategies to manage capacity and demand for community-based services. For example, Access to Care at Cancer Care Ontario is developing an MRI capacity-planning tool designed to advise the Ministry on LHIN capacity and need for MRI services. The tool considers wait time, population growth and existing services and will be used to support MRI services based on provincial need. LHINs—Local Health Integration Networks, Auditor General Report 2015 section 3.08, p. 330 (24 of 56).
QUAL ITY MATTERS: REALIZING EXCELLENT CARE FOR ALL
Contents
2 Foreword
3 Introduction
4 Executive Summary
12 The Case For System-Wide Quality
24 Quality Matters: A Health System Quality Framework
34 Delivering Quality Care
48 Understanding Quality Health Care
58 Fostering A Culture Of Quality
70 Conclusion
71 References and Further Reading
77 Appendix 1: Committee Terms of Reference
80 Appendix 2: Committee Membership
82 Appendix 3: Key Informants
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We improve Ontarians’ health by providing evidence to address challenges like smoking, healthy eating, and physical activity.
We transform data into interactive tools and resources to monitor population health.
Our educational program builds the skills, capacity and competencies in Ontario’s health workforce to face tomorrow’s public health issues.
Our experts guide and support health professionals with evidence and case studies on topics like immunization, environmental and occupational health, health promotion, infection prevention and control, and potential health emergencies.
Our research informs health policy, transforms clinical and public health practice, and advances laboratory science.
Public Health Ontario keeps Ontarians safe and healthyHealth Quality Ontario
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Thought of the Day – are there really cuts to health care or are the unions, public service and/or special interest groups misleading the people of Ontario?
For the past few months some members of the public service, many unions and special interest groups have been decrying purported cuts to the Ontario Health Care system.1These groups may not have reason to be protesting. 
