LHINs should have more control over health facilities: Kaminski

The former president and CEO of Sudbury Regional Hospital told those attending an Ontario Hospital Association Conference at the Holiday Inn April 16 that she thinks health care facilities should be administered by regional health authorities, instead of individual boards.

Vickie Kaminski left her position at the hospital 10 months ago to become the president and CEO of Eastern Health in Newfoundland.

Much like the North East Local Health Integration Network (NE LHIN), Eastern Health is a regional health authority. Its geographic catchment area includes Avalon, Burin and Bonavista Peninsulas (which includes the city of St. John’s).

Unlike the NE LHIN, however, Eastern Health takes care of the day-to-day decision making at the health-care facilities it administers. Boards exist mostly in an advisory capacity, and have little power, she said.

Kaminski said she thinks it would be a good idea if this was the case in Ontario as well, because the LHIN would have greater power to redistribute beds and other resources within its planning area.

At the same time, she said she would never have said this five years ago, but her experiences with Eastern Health have changed her mind.

“I think the LHINs are in a really unfortunate position,” she said. “They don’t have a lot of authority and accountability that’s independent. They can talk about what they’d like to see happen, but they can’t actually (do it). They need a lot of co-operation from other corporations, because every hospital is incorporated, every agency is incorporated.

“They need to be able to schmooze with them and talk it over. I’m not suggesting there needs to be a heavy hand, but it does take a lot more time and effort to get people to buy in.”

Often, LHINs are stuck in the middle between the boards of individual health care organizations and the province, she said.

“If the government doesn’t want to do something, they can say ‘You have to convince your LHIN it’s a good idea.’ If the hospital doesn’t want to want to do something, they can say ‘We don’t have to listen to the LHIN.’”

The CEO has had to deal with her share of challenging issues during her short time in Newfoundland.

Slightly more than a year ago, Justice Margaret Cameron released the results of a judicial inquiry into the fact that 400 women in Newfoundland received flawed hormone receptor tests at a facility administered by Eastern Health.

At least 127 patients later died, but it may never be known how many might have survived with accurate treatment.
“That is such an all-consuming issue,” Kaminski said. “You’re hard-pressed to find someone in Newfoundland that hasn’t been affected by it.”

She said the province recently gave an update on how Cameron’s recommendations are being carried out. Thirty-nine of the 60 recommendations have been completed or party completed. The province has also come up with a settlement for the patients involved in a $17.5 million lawsuit, she said.

Kaminski left Sudbury Regional Hospital just as the organization announced its plans to deal with a nearly $12 million deficit. When asked if she felt she was leaving one crisis to deal with another, Kaminski said “that’s health care...If you show me a place that’s quiet, I’ll show you a place that’s not doing much.”

Like Sudbury Regional Hospital and other hospitals in the northeast, Eastern Health is also dealing with problems related to alternate level of care (ALC) patients, she said. However, the ALC numbers in Newfoundland are quite a bit lower than in northeastern Ontario, with about 65 of them spread out over the 1,000 hospital beds administered by Eastern Health.

She said her organization is looking at some creative solutions to reduce the number of ALC patients.

In western Canada, families are actually paid to take care of their elderly relatives, and Eastern Health is considering implementing this system, she said.

“Often, you’d hear, ‘We’d take mom home, but somebody would have to quit their job.’ They’re saying ‘If we gave you $1,800 a month to look after mom, does that help you find somebody in your home that could help you do that?’” Kaminski said. “We’re looking at how we can apply the same sort of thing. I think that’s one of the areas we have to explore fairly deeply.”

Kaminski said she has faced challenges related to the province’s freedom of information act, which gives those requesting information extraordinary access.

She said she’s had to hire a staff of 15 people just to deal with access to information requests from journalists and opposition politicians.

“Final reports should be available,” she said. “But (for) all of the drafts that lead up to it ... I need to keep those drafts, and be careful what I put in drafts. Also, e-mail correspondence ... I’ve said to people, when you’re writing an e-mail, think about whether you’d like to see it on the front page of the newspaper.”

Kaminski said some of her experiences with dealing with disasters at the hospital in Sudbury, such as a fire at the St. Joseph’s site in 2007, have come in handy in her new job.

During her time with Eastern Health, one hospital she administers had to be evacuated because of flood threats related to a hurricane, and part of the roof of another hospital blew off during a period of high winds.

“What you see is the same kind of reaction from people. They pitch in and do what needs to be done.”