By Marvin Ross
Covid and staff shortages in healthcare has led the right wing Ontario government to hint that drastic innovations like privatizing may be required to give health care a new life. Sadly, they are blinded by their own ideology and a lack of understanding of the issues. That may sway some to agree with them.
I for one am impressed with how well the system actually works despite the problems but more of that in a minute. Ontario already has parts of its health system privatized and it is a disaster. Since the election of an earlier right wing government under Mike Harris and his Common Sense Revolution, long term care has allowed for profit homes. Harris would become chair of the Chartwell Chain of residences and Wikipedia estimates he received $3.5 million for his services.
During Covid, it was discovered that the private long term care homes had the worst outcomes with far more elderly dying in their care than in the not for profit or municipal homes. The situation was so dire that the military was called in to help and the troops were shocked at what they found.
In October, I wrote about a private chain that provides so called supportive housing to adults with disabilities and the conditions were barbaric. The Global TV news has just done a multi -part expose on a private chain that provides housing and supports for vulnerable kids. The series outlines the findings of possible human trafficking and mistreatment, over medication, and possible deaths which the government has ignored. In fact, the office that provided oversight was disbanded in 2018 as a cost saving measure by the incoming Ford government. The report on the chain was never completed as a result.
I cannot imagine anyone wanting that type of care throughout the rest of the health system. If we consider what is often put forth for a dual system, that makes no sense. The argument is to allow private care for those who can afford it and keep the public system. The problem is that we only have a limited number of doctors, nurses and other professionals. With a private system, many would migrate to there where they could earn a lot more money leaving very few staff for a public system.
As it is now, nurses are fleeing hospitals because they are overworked and undervalued. The government has capped their salaries to no more than a 1% increase. In order to fill in for vacancies, hospitals and long term care facilities are forced to bring in nurses from agencies at $120 an hour. Why not pay nurses what they are worth. The government categorically refuses to rescind the bill that restricts their pay.
The biggest problem with health care in Ontario is the stupidity of how it is run. As I explained in one of my op eds in the local paper, the problem is a rapidly expanding bureaucracy which has no value added component. Today, the Ministry of Health and Long-Term Care has two ministers and an associate minister devoted to mental health and addictions. In 2005, there was just one minister. All those chiefs need staff so that today we have one deputy minister assisted by three associate deputy ministers. In 2005, it was one deputy and one associate deputy.
Each of the above needs a fairly large staff to report to them to rationalize their existence. The more senior staff you have, the more juniors are needed. Going down one level we have the assistant deputy ministers who, today, number 14. Again, an entire bureaucracy is required beneath them to justify their existence. In 2005, there were only seven assistant deputies or one half as many as today. Has there been any improvement in care and delivery between 2005 and today as the result of this growth in bureaucracy?
No but there is a new organization called Ontario Health which has, I’m told, 30 Vice Presidents.
The provincial premiers are all demanding that Ottawa fork over more money but Ottawa rightly refuses unless their is accountability from the provinces on how the money is to be spent and how it was spent. Ottawa did give Ontario $450 million to improve the wait list for kids seeking mental health care. As a result, the wait list went from 18 months to 40 months and the money was used to develop a Centre of Excellence for mental health – more bureaucrats.
Despite this mess in health care and the delayed surgeries and long wait times, the system is working thanks to the dedication of the staff. At the height of covid, someone with Alzheimers in a good care facility for whom I was power of attorney, wound up in hospital. He was found one morning sitting on the floor at the foot of his bed and staff sent him to the ER at the University Health Network in Toronto.
He was suffering delirium from extreme constipation and was kept for months as he recovered. By this point, he needed long term care but his dementia had deteriorated to violent outbursts and he had to be watched by a staff person all the time. Staff were excellent, caring and compassionate and finally decided to refer him to the Toronto Rehab Hospital across the street where the psychogeriatric unit might have some success with his aggression. That would have made it easier to find him a placement.
Regrettably, he managed to escape from his wheelchair restraint, fall and fracture his hip. He was then moved next door to the ER at the Mt Sinai Hospital where the fracture was repaired. Sadly, and not unusual, he developed a pulmonary embolism and was moved into palliative care. Staff were kind, attentive and kept me updated on a regular basis so I could provide reports to his family in the US, the UK and Australia.
His passing was a tragedy but the care he received and the human contact and consideration was what we would all like. And this was at the height of the pandemic when staff were overworked and stressed.
I have other stories in a similar vein but it all illustrates how well served we are by a very dedicated, compassionate group of professionals.
They and the rest of us do not deserve the idiocy we see from our ideologue politicians.