Health spending a hard pill to swallow

What is the scoop on Ontario’s new budget as it relates to health care?

Home and community-care services will receive a funding increase of five per cent annually over the next three years. On the other hand, Health Minister Deb Matthews has said the province plans to stay the course on downsizing hospitals, meaning hospitals get no increase to their base operating funds in 2012-13 and won’t get one in 2013-14 either.

You’re probably wondering what this means for Sudbury and northeastern Ontario?

When it comes to homecare, the Northeast Local Health Integration Network (LHIN) issued a report in 2011 on the state of personal support workers in the region.

The report found a worrying lack of human resources in our region.

It also found problems surrounding training, pay, working conditions and the lack of respect accorded to the workforce.

Ontario’s Action Plan for Health Care, released last year, set out a plan to provide millions of new hours of homecare. Now, the province intends to expand the program, which is welcome news.

But here’s the rub: It will only be effective if the province addresses the poor working conditions and pay of homecare workers.

So, what does the lack of a base funding increase mean for Health Sciences North?
Well, this year’s budget has yet to be released, but last year the hospital had to decrease the budget of its surgical program in order to eliminate its deficit.

As a consequence, wait times for things like non-emergency back surgery, hernia repair or removal of gallbladders, to give some examples, is now well over six months.

I’m not saying this to lay blame at the feet of the hospital. Like all of us, Health Sciences North must do what it needs to do to live within its means.

The overall increase in health-care spending for next year is projected to be two per cent. In contrast, the public’s use of medical services in Ontario has been increasing at a rate of 3.5 per cent per year, while inflation in the health sector adds another 2.5 per cent on top of that.

Is this approach going to succeed?

Sure, pushing hospitals to optimize efficiency will yield savings and enhancing care in the community will help keep our fragile elderly out of hospital.

But in the long run, you get what you pay for.

It is OK to decide that enhancing care in the community is a priority and the place to find the new funding is in the hospital sector. After all, we expect our governments to govern, to make decisions.

But to announce downsizing of the hospital sector without any direction to individual hospitals as to what services to downsize seems most curious.

Should each of Ontario’s 149 hospitals decide on their own where to cut spending?

What the government did not say in the budget is the public’s expectations need to be lowered.

The province failed to spell out clearly what the public should no longer expect to get when they come to hospital.

It is tough to tell the electorate they may not get everything they wish for. That takes true grit.

Dr. Peter Zalan is president of the medical staff at Health Sciences North. His monthly column tackles issues in health care from a local perspective.