Governance and Funding: While police and fire services are usually municipal services, Emergency Medical Services (EMS) are typically controlled by provincial governments. In Ontario, regional municipal governments have responsibility for delivering and funding EMS. But even in Ontario the province plays a key role, strictly regulating EMS, providing funding for 50% of the approved land ambulance costs, and paying 100% of the approved costs for air ambulance, dispatch, base hospitals, First Nation EMS, and for territories without municipal government. Delivery: Like police and fire services, EMS is predominantly a publicly provided service in Canada. But businesses (Read more…)
Another LHIN-based initiative to restructure “non-urgent patient transfers” is underway. Non-urgent transfers are ambulance-like transfers for patients from hospital to hospital, from hospital to long-term care, or from hospital to home. While the cost of these transfers often simply come out of the hospital budget, austerity has made this more difficult. The latest restructuring project is in the North East – and is funded by the North East LHIN. Earlier this year, the government strongly endorsed a LHIN-wide plan for the South West. As in the South West LHIN, the North East project (Read more…) . . . → Read More: Defending Public Healthcare: Patient Transfer Changes Continue — Boon or Bust for EMS?
Ambulances are spending a little less of their time offloading patients according to the Ontario Municipal Benchmark Initiative (OMBI) public report for 2012. That is positive: time spent offloading patients to overcrowded hospitals could otherwise be spent responding more quickly to 911 emergency calls. Nevertheless, we remain far behind where we were a few years ago. The OMBI study reports EMS data for 12 large Ontario urban municipalities –and also Muskoka. It indicates: The percentage of time spent in hospital Emergency Rooms (“offload delay”) has declined from 18.7% of total EMS time in 2011to 17.8% in (Read more…) . . . → Read More: Defending Public Healthcare: Ambulance hospital delays improve – but we are still far behind
The provincial Ombudsman has followed up on his damning report on the privatized, non-ambulance patient transfer industry. The Mike Harris Progressive Conservative government privatized the patient transfer industry at the turn of the century, moving the work over from Emergency Medical Services (ambulance services). Two years ago, however, the Ombudsman and the CBC reported major problems in this newly privatized industry, including threats to patient safety and working conditions. Ontario residents would be better off taking a taxi to a hospital than one of the privately owned vehicles used to transfer hundreds of thousands of non-critical patients (Read more…) . . . → Read More: Defending Public Healthcare: Patent transfer recommendations remains secret
The Minister of Health and LTC has strongly endorsed the restructuring of patient transfer industry in the South West LHIN. This may set a new model for the private corporations that often move patients between health care facilities in vehicles that look, for all the world, like ambulances — but are not. For the first time, a LHIN-wide patient transfer provider has been chosen, with the goal of standardizing equipment and staffing qualifications. Health Minister Deb Matthews states:
“This non-emergency transportation approach is precisely the type of collaborative effort that will help transform the health care system in Ontario. (Read more…)
. . . → Read More: Defending Public Healthcare: Non-ambulance corporations to take over more EMS work?
From time to time there are rumors that EMS (ambulance services) and municipal public health services may move over to the tender mercies of the Local Health Integration Networks (LHINs), which fund hospitals, home care, long term care, and other health services. Fortunately– for these services — that has not happened yet. The government is starving the LHINs. According to the recently released Budget Estimates, the LHINs are still going to get $300 million less than what they got two years ago. In contrast, public health services (provided by municipalities but funded to a considerable extent by the (Read more…) . . . → Read More: Defending Public Healthcare: Ambulances and Public Health get cash while other sectors starve
ORNGE providing a vital service. Photo: Jason Edward Scott Bain
The Globe and Mail kindly lobbed a few questions for the disgraced, former boss of ORNGE, Chris Mazza to swat away. His responses, published in this weekend’s edition, suggest the government was fully onside with his vision — until the fur hit the fan.
He said he could not grasp why he suddenly became a pariah. “Until November, 2011, I was being incentivized, told I was doing grand things. Not just by my board and by investors, but by deputy and assistant deputy ministers. They cheered me on,
. . . → Read More: Defending Public Healthcare: Admitting the price of privatization (when it all goes bad)
The new Ontario Municipal Benchmarking Initiative public report indicates that ambulances (and by extension paramedics) are spending more and more time in hospitals. For the thirteen (mostly large) Ontario communities included, the median percentage of time ambulances spend in hospitals has increased from 15.5% in 2009, to 17.8% in 2010, to 18.7% in 2011.
That’s an increase by more than one-fifth in the amount of time spent in hospitals.
As the report notes “the more time paramedics spend in the hospital process equates to less time than they are available on the road.” Ambulance hospital off-load
. . . → Read More: Defending Public Healthcare: Ambulances spending 21% more time in hospitals
Health Minister Deb Matthews sticks to her guns alright, spinning a tale at yesterday’s legislative committee hearing suggesting she was unable to control ORNGE. The ORNGE boss stonewalled and manipulated the numbers, she claimed.
The shenanigans at ORNGE are shocking, but it takes some believing that the government could not have reined them in if they had wanted to. The government was funding the outfit after all. And in fact, when the stench got real bad, the government pulled them up pronto: getting rid of the CEO, the board, and all the private businesses they had set up.
. . . → Read More: Defending Public Healthcare: ORNGE: no signs of learning