This article has been amended to clarify a statement from the Cornwall Community Hospital.
The author of a new report on the Ontario government’s stated intentions to increase the for-profit delivery of certain services in health care visited Cornwall Tuesday, bringing with him a message of support for increasing investment in services at hospitals such as the one in Cornwall.
At What Cost? was authored by Andrew Longhurst for the Canadian Centre for Policy Alternatives, supported by the Ontario Council of Hospital Unions / Canadian Union of Public Employees, whose president Michael Hurley accompanied Longhurst on his Cornwall visit.
Both presented the report and its recommendations to members of the Ontario Health Coalition’s local chapter at the Cornwall Public Library. In his summary, Longhurst noted while there continue to be waiting lists for surgeries across Ontario, those wait times are better than in many other provinces. More germane to his point, Ontario’s existing wait times are better than those provinces that are further ahead in contracting out some surgical and hospital services to private, for-profit companies.
The report was commissioned in response to the Ontario government’s move to expand the involvement of for-profit providers within the health-care system through Bill 60, which passed earlier this year and allows companies to bid for and negotiate contracts with the government to provide medical services covered by provincial public health insurance. It’s already led to some increase in for-profit involvement, notably in examples such as the establishment of certain for-profit run surgeries within available operating rooms at The Ottawa Hospital.
In analyzing public accounts, information received through freedom-of-information requests, and research completed on the for-profit delivery of health care in other provinces, Longhurst recommended Ontario stop its current work to expand for-profit involvement in health care and invest that effort into maximizing the potential of already available facilities.
“First and foremost we should boosting staffing levels. Funding or staffing is required to perform surgeries and to have operating rooms operating during standard schedules (day times during the week),” Longhurst said. “This would be using infrastructure we’ve already paid for.”
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While there are no examples of expanded for-profit delivery of health services within hospitals in Cornwall, Winchester, and Alexandria, Hurley noted the Cornwall Community Hospital has unused surgical capacity that could go further to reducing waiting lists, instead of leaving people with the choice of waiting or going elsewhere — potentially to service provided by a for-profit company in Ottawa.
Hurley said only four of CCH’s operating rooms are currently in use, one of which is set up for procedures such as endoscopes, and routine surgeries are offered only one evening a week. He said he didn’t know whether that was due to a lack of surgeons and OR staff members, or a lack of funding, but supported the recommendation it’s better to ensure there’s funding through the hospital to expand the number of surgeries rather than turn over that availability to a for-profit provider.
“If the hospital ran its six ORs that would expand capacity by 18 to 24 hours a day,” Hurley said. “There are staff shortages, but we know you can incentivize (to address them). They could get the ORs up and running while bringing (new staff members) on stream.”
CCH responded to an inquiry to confirm Hurley’s statements, noting there are five operating rooms in full weekday use, one of which is set up for scopes. Surgeries are done in one OR every weekday evening and weekend days. The sixth OR is set up for cystoscopy procedures, where there is not enough demand to have it running full-time.
The hospital statement noted it’s not currently a question of funding for its ORs, but having enough human resources to have all ORs running full-time, evenings, and weekends.
Longhurst noted one of the challenges is governments tend to turn on the funding taps to address problems in health care when they become acute enough to threaten their political survival, then once the crisis is addressed, go back to austerity and turn off the taps.
“Stable funding has to come first, because then you can do the recruitment,” he said. “Eastern Ontario has a large population and it’s not far-fetched you would start to see those (for-profit provider) facilities. I’m under no illusion this won’t happen if this policy continues.”