Everybody who’s worked in health care knows what it’s like being kicked around by politicians.
If you were a health-care worker in the 1990s, like me, it was as if war had been declared upon you.
In that decade, doctors were singled out as the root of health care evil because they “caused” the precipitous rise in health-care costs.
The NDP government of the day decided that there were simply too many of them and therefore provided too many services to the public, driving up health care costs. Their answer was to shrink medical school enrolment in Ontario by ten per cent.
Fewer doctors would provide fewer services and therefore the rise in health-care costs would be controlled.
Of course, the government got its wish, but fast forward to today, and we can see the result of that move. In spite of ramping up medical school enrolments and even creating a new medical school in Northern Ontario, the demand for doctors outstrips the supply by a country mile.
The provincial government never considered the needs of an aging population or the needs of immigration increases.
The plan was easy to sell because doctors earned too much and nobody liked them anyway. They were the perfect target for politicians. And for Rae Days, when public sector workers were reduced to working and getting paid for only four days out of five, the doctors could keep on working full steam but only get paid for 80 per cent of their work.
That’ll solve the problem. Smooth move, Bob.
But wait. Pat Carr of the Ontario Nurses Association told me that at the same time nurses were identified as costing too much and, of course, they were replaceable. So their positions were replaced in part by registered practical nurses. Good workers, but with a reduced scope of practice and a reduced pay scale.
Nurses ranks started to shrink and kept getting smaller. They never recovered.
Fast forward to today and see what you’ve got. The biggest single bottleneck in hospital care is a lack of nurses, causing delays in care and closing emergency departments and intensive care units due to lack of staff.
Oh well. Now the political thinking goes … We’ll give them a few bucks to keep them from retiring and we’ll poach nurses from other jurisdictions. As if a lot of foreign nurses even want to come work in a health care system that doesn’t respect them and ranks No. 30 in the world (according to the World Health Organization).
Then there were the “fat” hospitals. Look no further than Sudbury to see what started in the ’90s. Our politicians took aim at them.
Our three hospitals — the Sudbury General, The Sudbury Memorial and Laurentian — with a combined bed count of more than 500, were merged into Sudbury Regional Hospital with a total bed count of around 365. Emerging technologies and day surgery were going to eliminate the need for so many beds. Besides, administration costs could be reduced.
Nice idea, but that’s all it was. An idea. That utterly failed.
Fast forward and see what happened. The recently renamed (at considerable cost) Health Sciences North rented hotel space to house overflow patients (in spite of adding new beds). Specifically, alternate level of care (a.k.a ALC) patients, typically seniors that don’t need a high level of care, but either can’t quite be discharged or have nowhere to go.
So along comes Bill 7, the amendment to the More Beds, Better Care act. This work of genius allows hospitals to discharge ALC patients — against their will — to other care locations such as nursing homes, as far as 300 km away from their present domicile.
That’s quite a long kick for a political football.
Let’s consider the thought process politicians must be using.
We’ve kicked the doctors around, but we need them. We’ve kicked the nurses around and now there aren’t enough of them to keep emergencies and ICUs open. Yikes, we need more of them, too. We’ve kicked the hospitals around so much that we’re subletting hotels to be makeshift hospitals. Darn!
But hey, it’s the seniors that are clogging the hospital system. We’ll discharge them. They’re easy. It’s hard for them to fight back.
Seems “Always There to Care” has come full circle. Health care has now been kicked around at all levels.
With the provincial premiers unable to coax more health care dollars out of Ottawa to spend willy-nilly on health care, will they be the next political football to get kicked around? After all the World Health Organization tells us Canadians waste about 40 per cent of their health-care budget.
Think of it this way. Would a responsible parent give a spendthrift child a bigger allowance because the child can’t get by on their money? Or would they teach them management skills?
There are still no concrete, comprehensive plans to re-organize health care into an efficient, functional platform in this jurisdiction. And why should there be when the ideological head of the health care system (the provincial party in power) changes every few years. Besides, the thinking must go that the next party in power can clean up the mess. That’s why we’re No. 30 on the world stage.
Is it time for politicians to acknowledge that they are either unwilling or simply unable to make this “health care thing” work? Is it time to sublet this important work to a responsible group?
Dr. Klaus Jakelski is a retired family physician and author. He resides in Greater Sudbury. You can learn more about him by visiting his website, Jakelski.com.
