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March 9, 2010 - No. 50
Health Care Is a Right!
Ontario Goverment Must Increase Funding
for Health Care! No to Privatization, Closures and Cutbacks!
• Ontario
Goverment Must Increase Funding for Health Care! No to Privatization,
Closures and Cutbacks!
• Schemes to Force Restructuring of Health Care
and Silence Opposition - Ontario Health Coalition
• Consultants' Report Advocates Competition for
"Patient-Based Payments"
Interviews
• Doug Allan, CUPE Research Representative
• Andy Summers, Vice-President, Ontario Nurses
Association
• Sue Hotte, Co-Chair, Niagara Health Coalition
• Denis Allard, Vice-President, CUPE 1101, West
Nipissing Ambulance Services
• Sue Brown, OPSEU, Local 636, North East
Mental Health Centre, North Bay
• Sheryl Ferguson, President, OPSEU Local 431,
Providence Care Hospital, Kingston
• Mike Tomatuk, CUPE 4313, Payukotayno Child
and Family Services, Moose Factory
Health Care Is a Right!
Ontario Goverment Must Increase Funding for Health
Care! No to Privatization, Closures and Cutbacks!
Health care workers across Ontario are reporting a huge
increase in closures and cutbacks of health care services and layoffs
of health care workers, across the spectrum of services including
services to seniors and the mentally ill. Hospital departments,
emergency rooms, a high number of beds and even
entire hospitals are being closed. Accompanying this wrecking is an
intensified push for the privatization of services. The situation is
particularly critical in small, rural and northern towns, although
larger urban areas have not been spared either.
 Decades
of
underfunding of public health care and
especially in the last few years is coming home to roost. Maintaining
health care
budgets below inflation level under the hoax of "taking the
economy into account" means the system is more and more unsustainable
and this crisis is used by the goverment to further privatize the
system. The Liberal
government has
refined the anti-social offensive of the Rae
and Harris governments. With great duplicity, it professes
support for public health care, while in reality, it continues to deny
the health
care system the necessary funds to ensure the well-being of Ontarians.
Rather than the bald-faced anti-social offensive of Harris, the
McGuinty government has implemented a
process whereby anti-social measures in health care are implemented
by the cabinet-appointed regional health authorities (Local Health
Integration Networks -- LHINs), hospital boards and other bodies. Using
a system of penalties and rewards based on their willingness to perform
the drastic cuts under the hoax of eliminating their deficits,
hospitals in a given region are pitted against
one another. The alternative is for cuts to be imposed from above by
the LHIN if deficits are not eliminated. These schemes
facilitate the diversion of even more of the social wealth away from
health care and other social programs to put it at the disposal of the
monopolies. These schemes also facilitate the increasing hand over of
services to private for-profit monopolies which
have no place in the public health care system.
TML reiterates the demand that the Ontario
government immediately increase its funding for health care and stop
its privatization, closures and cutbacks. The Ontario workers and
people have been plagued with successive governments from Rae to
Harris-Eves and now McGuinty which have refused
to recognize that health care is
a right that has to be provided with a guarantee. Cutting back the
funding of
social programs takes more out of the economy than what is put back,
which is worsening the economic crisis. This wrecking by a government
in the service of the monopolies is
causing maximum insecurity. It must not pass!
TML calls upon all workers to step up the
fight in defence of the right to health care. A crucial part of this
means dealing with the question of how to provide Ontarians with a
government and economy that
represent their
interests.
Schemes to Force Restructuring of Health Care
and Silence Opposition
- Ontario Health Coalition,
December 2008 -
(Excerpts from
"Briefing Notes on Ontario's Hospital Cuts and Restructuring 2008/2009.")
Cross Province Hospital Cuts and Restructuring
 A major round of hospital
restructuring and cuts is
underway across the province. This year and next, provincial budget
levels for hospital global budgets are insufficient to meet hospital
rates of inflation and population growth. Cabinet-appointed Local
Health Integration Networks (LHINs) are reviewing services in hospitals
with deficits, and at the behest of the provincial government, are
forcing hospitals to eliminate their deficits. Cuts are occurring in
every health region of Ontario. The proposals include closures of
Emergency Departments; closure of local birthing
services; cuts to hospital departments and beds; essential closure of
small and rural hospitals; privatization of physiotherapy, chiropody
and support services; lay offs and attrition to reduce the size of the
hospital workforce; increased fees for patients and their visitors, and
other measures.
Province-wide at least 50% of hospitals (75 hospitals)
are, or have been, in deficit this year and almost 70% (104 hospitals)
are projected to be in deficit next year. Some have signed
"accountability agreements" that contain service plans to reduce or
eliminate their deficits through cuts, centralizing
and rationalizing services, lay-offs and attrition. Cuts to eliminate
this year's deficits are now underway across the province, and, given
the global funding levels the cuts are scheduled to deepen and spread
over the next year.
Centralization of Services, Threats to Small and Rural
Hospitals
The province is reducing the proportion of hospital
funding for global budgets in a planned squeeze. New funds are not
assigned to global budgets but are directed towards particular target
procedures. The theory behind this restructuring
is that it will force hospitals to specialize and centralize services.
The government has not made public how far patients will be required to
travel as services are centralized, and infrastructure planning has not
been aligned with the service restructuring.
The planned inadequate funding for this year and next
has meant that budget deficits exist across all sizes of hospitals and
the entire geography of the province. Large-scale lay offs and cuts
have been announced at larger hospitals. However, the current
centralization proposals pose a particular threat
to small and rural hospitals. Notably, despite promises from the Health
Minister and the Premier not to close small and rural hospitals,
proposals are now in process that raise concerns that small town
emergency departments will be closed. In several cases the cuts, if
implemented, would effectively close small and
rural hospitals and turn them into clinics.
Secrecy, Lack of Public Access to Information
It has proven impossible to track how many hospitals
have signed agreements to cut services. Hospitals have reportedly been
asked to sign "communication protocols" with the LHINs governing what
information will be released to the public and when. In a number of
cases full plans for budget cuts are not public.
A number of hospitals have continued to refuse to sign accountability
agreements, while other hospital boards have publicly split on the
issue. Some accountability agreements and service agreements appear to
be secret, while other plans are being made public.
Scope of Hospital Deficits: Overview
Information leaked from the Ontario Hospital Association
last spring reveals that their hospital survey found that seventy-five
(75) hospitals face deficits in 2008-09. The situation is forecast to
worsen in 2009-10 with 104 hospitals facing deficits that fiscal year.
Hospital budget deficits are leading to cuts to patient services in
hospitals of every size in every region of Ontario. The McGuinty
government previously announced global funding increases that will not
meet inflation and population demographic changes for this current
fiscal year and next. The funding increase
for this year was announced at 2.4% to decrease to 2.1% next year.
Process for Cuts: Overview
The government has required hospitals by law to balance
their budgets and sign "accountability agreements" containing plans to
eliminate their deficits. Where hospitals have refused to sign these
"agreements," the Ministry has imposed them through the LHINs. The LHIN
legislation gives 90 days for negotiations after which the LHIN imposes
a set of directives ultimately resulting in an order to sign the
"agreement" after which the service cuts can be imposed. Last spring
the Ontario Hospital Association recommended that hospitals should not
sign accountability agreements that require
cuts and/or are unfeasible.
The Ministry of Health has provided a set of steps for
hospitals to find increased revenues or cuts to balance their budgets.
These start with increasing revenues through parking fees and space
rentals. They then move to cuts and rationalization of services,
starting with support services and progressing
to clinical services. In the LHIN legislation, the government has given
itself and the Local Health Integration Networks (LHINs) new
restructuring powers to order transfers, amalgamations and closures of
services across their vast geographic areas. The Ministry of Health is
moving away from global budgets for hospitals
to price-based competition for hospital funding which will centralize
services away from local communities, with powers for the LHINs and
Minister to supercede local hospital board's decision-making powers and
community need. This has been done in the U.K. where it has resulted in
significant privatization, high
administrative costs, longer waits and cuts for some services, and
massive protests as local hospital programs are moved or cut. Hospitals
have been required to submit service plans to eliminate their deficits.
If the hospital refuses to eliminate its deficit, the LHINs are sending
in consultants to find cuts. In some cases,
hospitals have brought in consultants to find cuts. In others,
hospitals have brought in consultants to review plans for cuts. To
date, we are not aware of any of these consultants recommending against
cuts, though in some areas consultants have recommended less cuts than
required to eliminated the hospitals' deficits.
Under the LHIN legislation, the Ministry of Health and Long Term Care
has given itself the power to force accountability "agreements" in
cases in which they are not agreed upon by the local hospitals.
Consultants' Report Advocates Competition
for "Patient-Based Payments"
The Ontario Liberal government is openly advocating that
hospitals must be financed on a "patient-based payment" system, a move
that will step up the privatization of the health care services if it
is implemented. The McGuinty government is paying a large sum to
consultants whose mandate is to figure out
how to impose such a system in Ontario.
According to details from a consultant's report
revealed
in a recent Toronto Star item,
the
plan
would pit hospitals in a given region against one another by
competing to see which one could perform acute care in-patient
surgeries and treatments such as hip replacements more cheaply than the
others, with the lowest-cost bidders
getting more of the work. It is estimated that this "patient-based
payment" would permit further "savings" of 10-20 percent of the $18
billion
currently budgeted for Ontario hospitals. Under this system, hospitals
would be paid according to the number of
patients treated and also based on what the government
determines to be "successful treatment" of patients. Besides
encouraging hospitals to cut corners, "savings" would also come from
reducing "duplication" of services, meaning that services would be
centralized at the "lowest-cost" hospitals. Patients would have to
travel across town or to other municipalities even
more so than at present with the current closures and restructuring of
services because hospitals would likely narrow the range of services
and
procedures they offer in an attempt to maintain access to funding.
 When challenged in the Legislature, the McGuinty
government did not rule out that a "patient-based system" may be
implemented. It claims that it does not want to hand out money to
hospitals for general use because it does not know how the money is
being spent and whether there is "good value" attached
to every dollar spent.
In a March 5 communique, Michael Hurley,
President of the Ontario Council of Hospital Unions wrote that
Ontarians should be alarmed that the Liberal government is planning a
radical restructuring of health care "premised not on quality of care
and best practices, but solely on which hospital
can do their surgeries most cheaply." If implemented, that
competition between hospitals would be a "fundamental shift in how care
is delivered -- a shift that has proven disastrous wherever it has been
tried, in Britain and in Ontario," he said. Pointing to the rampant
privatization in home care in Ontario, he added
that "Competition in home care has meant the quality of care has
suffered and costs increased as more private, for-profit providers have
won contracts.... The Liberals never consulted about this kind of
health care reform. Now that we are aware that the Liberals intend to
treat surgeries and hospital care like a consumer
good, Ontarians will mobilize."
Interviews
Closures and Cutbacks in the Name of "Integration"
- Doug Allan, CUPE Research
Representative
 In hospitals across Ontario
there are very long delays
for the paramedics because the emergency rooms are so backed up with
patients and the paramedics are not able to hand over their patients to
the staff. This problem is compounded as the government moves
to close down emergency rooms in smaller
communities. This is what happened in the Niagara region where the
emergency rooms in Fort Erie and Port Colborne have been closed and
transformed into urgent care centres which provide some care but not
the 24/7 emergency services that are required. Generally there is a
significant move to regionalize hospital
services which essentially means to centralize services within a
region. Small, rural and northern hospitals are the most vulnerable in
these circumstances as their services are being moved out of the area.
This is the case for example with the Burk's Falls Hospital in the
Muskoka area where the urgent care centre
was closed without warning and a high number of beds were closed
forcing people to travel long distances for the care they need.
 As this is happening, we
have Health Minister Deb
Mathews saying that the cutbacks and closures are actually going to
improve the health care services because the lost services will be
replaced by home care in the community. This is a very old argument
dating from the time of Harris which has been
proven wrong time and time again because the support is not there in
home care and other care in the community while the budgets of the
hospitals are being more and more squeezed. What happened with the
pledge of the McGuinty government that it would increase the funding of
the Community Care Access Centres (CCACs) which oversee home
care and that this did not happen? The home care sector is in crisis
today and this has been the case for many years. To think that adequate
funding for community care can be done at the expense of the hospitals
is nonsense.
The Liberal government has taken over where Harris left
and it is doing so in a very duplicitous way not exactly like the
Harris government which wore its ideology on its sleeve. This
government is putting a lot of pressure on others such as the LHINs and
the hospitals to cut the services and it is doing
so in an atmosphere of secrecy in which it is very difficult to have
access to the information. This government has absolutely no public
process; everything is done behind closed doors. This government likes
to coin slogans such as "integration" which look good when actually
what it means is that the services are
being centralized within the huge regions covered by the LHIN's and
people lose their services and have to travel long distances to get the
care.
The Liberal approach is much trickier, we could say
smarter than the approach of Harris but things are coming to a clash
now with the increased amount of closures and people in the rural area
are realizing that the hospitals to which they have made huge donations
to keep alive are being undermined
by stealth.
Critical Mass of Closures and
Cutbacks
in Health Care System
- Andy Summers,
Vice-President, Ontario Nurses Association -
A lot of health care facilities and programs are
presently being closed or consolidated with other hospitals. One of the
consequences is that the community has to travel even further to get
the services they previously accessed locally.
At the Ontario Nurses Association (ONA), we see a
definite attempt by the health care
authorities to get rid of nurses. Wherever the hospitals can, they are
doing two things.
 First, they are cutting
back the nursing services to
their bare bones. Second, they are reducing the skill requirements to
give the care. Where previously it was the norm to have a registered
nurse (RN) to provide the care, they are using registered practical
nurses, which is a lower skilled nurse. Where
a registered practical nurse (RPN) was required, hospitals are
replacing them with a personal support worker. We are seeing that
happening in many hospitals including in big cities like Toronto. We
have of course the example of the Ottawa Hospital which is the most
recent place where we have heard about this.
The Ontario Hospital Association has given the mandate to all its
hospitals to replace a registered nurse with a registered practical
nurse wherever it is possible, not for better quality care but for cost
savings. At Humber River they are getting rid of registered nurses in
the emergency rooms and replacing them with
RPNs. The emergency department is not the place to reduce the skill of
the health care work. At East General, nurses are being moved from
areas where that have been working for 20 years to other areas of the
hospital. Nurses are now very specialized -- you do not ask a brain
surgeon to do cardiac surgery. We
are experiencing both the reduction of nursing staff and attempts to
deskill it.
The Ottawa Hospital announced recently that it is going
to cut a third of a million hours of RN care per year to balance its
budget. Health Minister Mathews is saying that this will help provide
better care in the area because it means that health care is going to
move out to the community.
Care based in a community is excellent. It is the
standard model we should all aim for. However when there is no care
available in the community, cutting back 300,000 hours of nursing care
is never going to improve the care in the community. The cuts at the
Ottawa Hospital are not based on having
quality health care. They are based on budgets. I do not think that
quality is a factor when they lay off nurses in Ottawa. It is also
unacceptable for the board of the hospital to say that they are
actually cutting positions and not necessarily jobs. They want to
create acceptance that these lost positions should never
be replaced, that we should be permanently short-staffed, that they
should not hire under the guise of eliminating vacancies. These cuts
are being done to real people. Closing beds is decreasing the service
to the community.
Those kinds of things have been going on for a quite a
while but we are now reaching a critical mass where people are seeing
very clear cuts. We have started to see these cuts happening especially
in the last two years where the Ontario government has passed health
care budgets that are well below
inflation. The proposal for the upcoming budget is that it will be
between a zero to two percent increase and both are unacceptable and
are
going to make things worse. There is a chain of command from the
Ministry to the LHINs and to the hospitals and other health providers
to impose cutbacks. I am convinced that
the LHINs were created by the provincial government to shield it
against
criticism for its actions. The government is
abdicating its responsibility when it puts the blame on the LHINs and
on the hospitals. I am not saying that the boards of the hospitals are
innocent but I understand the pressures
that are being exercised from top to bottom.
I have a long experience as a nurse in an emergency
room. Today the ministry is saying that the changes in the emergency
rooms are central in the changes to the way that health care services
are delivered to the people. The ministry is saying that the emergency
room may not be the ideal front door
to the health care system. It is saying that people can access the
system through walk-in clinics or through family health teams, etc.
They are trying to get the people to leave the system faster by
discharging them faster and sending them back home faster, back to
community services. At the same time, there is a
huge back log in community care. The issue is that the symptom of
the crisis is more visible in the ER. The government is saying that
first it wants to deal with the wait times in the emergency rooms in
order to avoid dealing with the whole health care system as a process.
It is the whole system which is at fault
when the emergency rooms are backed up. To highlight the amount of time
that people spend in the emergency rooms and to make it the issue is to
hide the problems that the whole system is facing. One measurement
cannot explain everything.
Also, if you take the argument that was given by the
health care authorities to close the emergency rooms in Fort Erie and
Port Colborne, it does not make sense. They said that what people need
in the area is a high level trauma centre and I can appreciate that.
But why does that mean asking everybody
to now travel a vast distance to go to the emergency room, while these
emergency rooms that were closed played their role in saving people's
lives? This kind of restructuring which is done behind our backs is
going to increase the death rate. These closures are now reaching a
critical mass and we have no choice
but to fight back by uniting all the unions and the health coalitions
together and looking for a political solution to the problems.
Heath Care Cuts in Niagara
- Sue Hotte, Co-Chair,
Niagara Health Coalition -
The Niagara Health System (NHS) is a large system that
has been underfunded for a long time and as you know the health
providers in Ontario are not allowed by law to run deficits. The NHS
hired a doctor at the end of 2008 who came up with a report which was
adopted by the Local Health Integration Network (LHIN) of our region
which
said that services had to be cut including beds. This is how it
started. In an effort to do that, the emergency rooms and most of the
hospital services in Fort Erie and Port Colborne were closed in the
summer and fall of 2009. On top of that they have been closing beds in
St. Catharines, Niagara Falls etc. It is not
so much that people have lost their jobs. What has happened is that
all their positions that they had vacant are not being filled. Jobs are
being eliminated through attrition. Front line workers now have to do
more work to be able to meet the needs of the people. The people of the
area are being put at risk and we
now have two people who died in a situation where they had to travel
longer distances than before to go to the emergency. There is going to
be a coroner's inquest into the death of one of them and we hope that
there is also going to be an inquest into the death of the second
person.
 What is happening in our
region is also happening
across the province as the McGuinty government is using the back door
to reduce hospital services and close ERs throughout rural and small
town Ontario. They are putting pressure on the LHINs and the hospitals
so that they shut services down under
the hoax that they are not allowed to run deficits. It is in the
Niagara region that we have seen the biggest impact of that so far. It
has a big impact on the people, not only by the anxiety it creates but
it is also a big burden economically as our people who are transported
to emergency rooms far from where they
live have to make their own way back and this can cost as much as
$100-150 in certain cases. Overall the waiting time in the ERs in our
area is between 17 and 20 hours.
According to Minister Mathews, people who get kicked
out of the hospitals when the services are cut are being looked after
in the community but the changes that have been promised in order to
improve community care have not materialized. For example, we do not
have enough long-term care beds
and this is creating a serious problem for our seniors especially those
who have complex care issues.
In home care, the conditions are not there at the
moment to face the work load of increased home care and the workers are
not paid appropriately for the type of work that they are doing. The
working conditions in home care have also become worse because a lot of
home care has been privatized.
Seniors are being sent to retirement homes which are not equipped to
deal with this situation.
We have organized a lot of actions in the area to stop
these closures. We have held demonstrations, town hall meetings, we
have circulated petitions, written letters to the media, etc. The
participation of the people of the area in these actions has been very
broad so when we hear Minister Mathews saying
that the people of Niagara support these closures we say that she lives
in la-la land. The people were never consulted prior to these changes
and many municipalities have actually called for a moratorium on these
changes. These changes are being decided behind closed doors. The
authorities are changing by stealth
the way that health care is being delivered without any public debate.
They are creating a crisis in the health care sector.
Attempt to Privatize Ambulance
Services Defeated
- Denis Allard,
Vice-President, CUPE 1101,
West Nipissing Ambulance Services -
 In the summer of 2009, we came
down to the possibility
of the privatization of the ambulance services. The approach from the
operator, the West Nipissing General Hospital, was that they just
wanted to get rid of the service after 30 years of operating it.They
said that it was not part of their future mandate and
that by December 31 they were getting out of the delivery of the
service when their contract expired with the social services
administration. It did not matter to them if the service went public or
private. From their point of view, they just wanted to get rid of us.
There were tenders out including ones from private
providers. From our perspective we are happy that the contract went to
a public institution which is the North Bay General Hospital which is a
lot better than going private. The private provider in the nearby
Gravenhurst area has already caused
dramatic changes in the operation for the same kind of services.
We waged quite a fight to make sure that the service
was
not privatized. With the assistance of CUPE Ontario and some of the
local paramedics we put a campaign together to educate the regional
residents on how things are run, how the ambulances would be affected
and
that privatization could definitely cost lives. We showed that
privatizing the services would be life
threatening. There was a big mobilization regionally, not just locally.
People got involved from all areas. By approaching the District of
Nipissing Social Services
Administration Board, we were
able to express our concerns and the tender was modified to meet our
needs by including the expression "enhancement of the service." So the
work remained in our hands and includes the possibility
of the betterment of the service by the inclusion of that language.
I believe the public sector is the way to go for
hospital care and it has to be kept public.
Opposition to Cuts to Mental Health Services
in North Bay
- Sue Brown, OPSEU, Local
636,
North East Mental Health Centre, North Bay -
There is a proposal by the LHIN to transfer 31
psychiatric rehabilitation beds out of the city of North Bay. The
decision has not been made yet and we are putting together a proposal
to ensure that the beds and the jobs stay in North Bay. We have put
pressure on the local MPP and she is now pledging to ask for a
moratorium on the decision, which is supposed to
be taken at the end of March, but we are still awaiting the answer to
that. If the decision is implemented, this is going to seriously affect
the patients and the workers. First of all, as far as the patients are
concerned, the North East Mental Health Centre (NEMHC) is their home
where their families come to visit them. To move them to Sudbury would
actually be quite cruel as it would affect the quality of life. Then,
the jobs are no longer going to be needed if the beds are not here.
That money going to the local economy is gone. This area cannot afford
to lose any more stable well-paid
jobs. The jobs that are coming off and on to North Bay end up being
part-time low paid and people end up leaving because these are very
unstable jobs such as jobs in call centres. They are not full-time jobs
with benefits that actually put money back into the local economy.
These are very low-grade jobs while what
we need is well-paid jobs so that we can live here and put money back
into the community.
The North Bay City Council voted unanimously to keep
the 31 beds in North Bay. This gives us some good leverage to make the
LHIN understand that the opposition is quite broad among the people.
It is a shame that the LHIN can make a decision when
people think differently. The LHINs represent a form of downloading of
responsibility and accountability from the government. How come all of
a sudden they get a few people on a board and they become the experts
of what should happen in
health care? To my mind it is very wrong. It takes away the
responsibility of the Ministry of Health even if I am quite sure that
the ministry has quite a lot of input into these decisions, although it
likes to say that this is not its decision but the decision of the
LHIN. The LHINs do not know what each community
needs. The elected officials are supposed to know and they should have
a say in that. When we go to the MPP who is elected to represent us and
we are telling her that we would like her to put a stop to that, all
she can do is to request a moratorium to delay the decision because
this is a decision of the LHIN.
The issue is not settled yet. The people of the area
are very much opposed to this announcement and we also have a brand new
hospital that is being built and is going to combine the NEMHC and the
General Hospital. When you merge two big facilities, you do not need
all the staff. They are telling
us that there are not going to be job losses but I do not believe what
they say. There are going to be more job losses because they are going
to say that they do not need all the kitchen or cleaning staff for
example.
Cuts to Health Services in Kingston
- Sheryl Ferguson, President,
OPSEU Local 431,
Providence Care Hospital, Kingston -
The Providence Care Hospital is a corporation that has
two hospital sites: the Mental Health Services and St. Mary's of the
Lake. The site where I work, the Mental Health Services, provides
specialized mental health care including adult treatment,
rehabilitation, geriatric psychiatry and we also have a forensic
psychiatry program which provides in and outpatient care. St. Mary's of
the Lake provides complex continuing care for people who require not
acute hospital care but ongoing complex hospital care for example in
the case of complicated strokes, cardiac recovery, knee and hip
replacement, those kinds of complex
medical issues. The corporation also runs a long-term care home that is
called the Providence Manor. The hospital is very central to the whole
region.
On February 16, there was an announcement that the
hospital is reorganizing and eliminating front line care positions.
This followed the report of the Corpus Sanchez International
Consultancy, which is made up of experts in the efficiency of the
delivery of health care services. A lot of the LHINs
are using them to restructure services in the hospitals. What is
interesting is that the decision of the hospital has nothing to do with
the recommendations of the report, which did not call for the
elimination of front line care positions. This is the decision of the
hospital alone and among the people targeted are the
two union Presidents, myself and the President of the St. Mary's local,
Local 483. We see this as a targeted move by the hospital. All the
cutbacks that it is proposing to do are on the backs of the workers.
They are cutting six full-time people who provide intensive support to
patients in the Mental Health Services
site. This represents among other things 6,000 hours a year of direct
support to outpatients in mental services which are being taken away.
With the desinstitutionalization of health care, we are sending more
people on the streets with serious mental issues and they are now
taking away 6,000 hours of support from
those people. People are being sent back to the community without the
proper support.
Other positions that are being targeted will actually
eliminate community treatment teams which look after the sickest of the
sick people in the community. These are patients who form a very
volatile group of people, with mood disorders for example, and
positions in forensic psychiatry are also being
eliminated even if this is where we find some of the most at-risk
people in the mental health services. This makes absolutely no sense.
We have to understand that mentally ill patients are
already way down at the bottom of health care. These are patients with
persistent mental health issues whose conditions include health issues
that are later to be diagnosed, whether cardiac issues, cancer,
diabetes, high blood pressure, a variety of life
altering illnesses. The support for these people is being taken away.
According to the policies of the LHIN, hospitals are
not allowed to reduce services unless everything has been done to
generate revenue. It is not true that the hospital has done everything
to avoid cutting services. The net result of these cutbacks is that
there will be fewer people on the floor looking
after more patients.
This announcement is happening in the context where the
hospitals do not yet know what their budget will be for this year
2010-2011. So most hospitals operate on the basis of a zero increase.
We are told that this is happening because of the economic situation.
There is no consultation with the people
on what the health care budget is going to be in the upcoming budget of
the McGuinty government. People are very concerned over what it means
in accessing what we consider a right.
Underfunding of Children and Youth Services
in Northern Ontario
- Mike Tomatuk, Spokesperson,
CUPE 4313,
Payukotayno Child and Family Services, Moose Factory -
I represent the workers of the Payukotayno James and
Hudson Bay Family Services. We serve the community of Moose Factory
which is located on Moose Factory Island in Northern Ontario. Our town
has a population of about 3000 people but we serve a population of
approximately 8,000 which includes the
people of the coastal community as well. Our agency serves both the
Aboriginal and non-Aboriginal population and provides a very broad
range of services to community such as child protection, child care,
foster care and many others. We have early intervention workers,
community support workers, special needs
workers etc. and also run a group home. We are operating under a
mandate from the Ministry of Children and Youth Services. We were
facing a cut off date of December 14 for possible foreclosure. On
December 14, layoffs notices were delivered to all the employees of the
agency, all the supervisors, middle management
and senior management. Our situation is directly related to the
underfunding of the Children Aid Societies by the Ministry. In our
case, a $3.6 million funding shortfall due to government underfunding
meant the possible closure of the agency. Many agencies are in dire
straights, but our agency has unique circumstances
because when we receive a call to visit a family many times the only
way that is available is to fly in because of the distance or the
weather. This means higher costs of transportation and more time spent
by our workers doing the visits. We are operating under a mandate of
the ministry according to which we have
to respond to emergency calls within a time frame of 12 hours but we do
not have the financing that allows us to do that.
We were scheduled to close, which would have been a
disaster for our community, but on December 9 we heard that the
Ministry had put forward some funding that will keep us going to the
end of March 2010 which is the end of the fiscal year for the agencies.
So the closure did not take place. This
is due to the work of the union and of the members of the community. We
were able to put a lot of pressure on the government. We are not sure
yet how much our financing will be for the fiscal year beginning April
1. We do not want to be in the same situation that we were in at the
end of 2009. The Ministry
has to increase the funding of the agencies. The Children's Aid
Societies
need appropriate funding. In our case, we are operating under the same
mandate as the others but our conditions are different than elsewhere.
(Photos: TML, Ontario
Health Coalition)
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