P3 or Private, Profiteering, Propaganda

I’ve been studying various documents for quite some time in order to blog about P3’s. I’ve read documents on schools, hospitals, utilities, and roads and in each and every instance there has been more cost to the taxpayer, erosion of service, job loss, wages rolled back, and loss of public control and government accountability.

The statistics and reports are quite astounding. Take this one for instance:

Between October 2003 and July 2004, housekeeping services in all 32 hospitals in the Lower Mainland

and southern Vancouver Island were privatized (see Table 1). Many of the same hospitals and some LTC

facilities also contracted out their dietary, security, and laundry services during this period. (Not all regional

health authorities or health care employers in BC chose the privatization route: the Interior and Northern

health authorities did not privatize support services; the northern end of Vancouver Island was also left

in-house.) By March 2004, approximately 6,500 housekeeping, food, laundry, and security workers affiliated

with the HEU and the BC Government and Service Employees’ Union had lost their jobs; another 2,000

were gone by July 2004.

This wholesale dismantling of in-house health support services has no Canadian parallel. The closest

match is Alberta, where two of Calgary’s four hospitals privatized their housekeeping services; however,

Calgary chose to introduce changes over an extended period. In BC the rate and pace of change were

stunning: 8,500 health care support jobs vanished from the public sector in under a year.

--snip--

Not surprisingly, these blatantly involuntary partnership agreements between

Local 1-3567 and the companies had a number of negative features. The

agreements run for six years, unlike the typical labour contract of two to

three years’ duration. The 2003 Aramark/IWA Local 1-3567 agreement for

health care started a housekeeping aide at $9.50/hr, rising to $11.21/hr after six years.5 The median wage

for housekeeping aides across the three IWA Local 1-3567 agreements with Aramark, Compass, and Sodexho

was $10.25/hr.6 In comparison, the wage for the same job under the HEU’s Health Support Subsector

collective agreement was $18.32/hr – 79 per cent higher than the privatized rate.

Contracting out effectively wiped out more than 30 years of pay-equity gains for British Columbian

women in health housekeeping jobs.7 Further, the province went from being a national leader in pay

rates for health support services to being the lowest in the country, significantly lower than the Canadian

average. In 2003, a privatized cleaner in a BC hospital was earning 26 per cent less than the national

average union wage for the job.8 This decline in income is especially punishing in light of the high cost

of living in Vancouver, where housing costs are steeper than anywhere else in the country.9

--snip—

Despite these absences, the majority of our participants said they were reluctant to take time off for health

problems. Just under half of our participants said they would call in sick only if they were incapable of

working. Some reported to work despite poor health. One housekeeper worked with the flu because her

contractor was very short of staff; another ignored an injured knee and, after three months, was in considerable

pain.

Their reasons suggest a corporate strategy of discouraging paid sick time by pitting the worker’s physical

well-being against their economic survival. Many workers said their employer had a strict requirement

to provide a physician’s note if they called in sick, even for one day. The deterrent is obvious: getting

an appointment on short notice is not easy, some physicians charge money for notes, and sick people

often don’t feel like getting out of bed to see a doctor. A lead-hand housekeeper spoke proudly about challenging the company’s policy of requiring a note after one day’s illness. As a result, a note is necessary only after an absence of two days or longer.

Workers were aware that repeated absences could be grounds for dismissal.

“Nobody wants to call in sick because they’re afraid,” said a cleaner and

former in-house worker. “Now if you’re sick two times and go home, that’s it. You’re fired.”

From a patient perspective it is just as scary. 10% of patients leaving British PFI hospitals are malnourished, cleaning staff have been cut back to the point that hospital infections are running rampant and leading to preventable deaths.

Schools built in the P3 style are at the mercy of corporations. They want to make money above all else. This has resulted in school activities being cancelled and/or costing significantly more as gym rentals cost so much more. Most parents are concerned about good nutrition for their children and that their kids not be subjected to advertisements while in school. Unfortunately parents have little or no say. The P3 owners make contracts and the schools must accept them. Many schools are finding that construction was badly done and school boards are on the hook for repairs. In at least one instance children were not allowed to hang artwork or play on the grass, as this would depreciate company property.

The 407 Highway in Ontario is a P3. Leased for 99 years to a private consortium the government has little or no say about tolls, safety or any of the other problems associated with the highway.

On June 9^th 2006 highway 401 was tied up for four hours:

…..when a private clean-up crew demanded payment up front before it would clean up a diesel spill. "Whenever we are doing anything on the highway, we have to be sure we're going to get paid," Bob Chabot, owner of Centennial Sweepers, told the media. "We can no longer afford to subsidize the province of Ontario."

Because of situations like this the government is reconsidering these contracts right? Wrong! In fact:

Earlier this year, former Transportation Minister Harinder Takhar announced pilot projects for so-called 'Area Term Contracts' (ATCs) for provincial highways. Unlike the current Area Maintenance Contracts, which generally last five years and cover only basic road upkeep, ATCs will last up to 20 years and cover not only maintenance but also all road reconstruction and rehabilitation.

"Under the government’s plan, giant corporate entities will have total control over every aspect of our highways – except paying for them," says O’Brien. "That will be left to taxpayers. We’ll have to pay a pretty penny, because there is no way a company can risk signing a 20-year contract without making sure its expenses and its profits are secured by a fat cushion of our tax dollars."

The appeal of P3 for governments is that it allows them to hide debt and have the public believe they are keeping to budget however, it will end up costing the taxpayer much more over the long run, gives us less control over public areas and in Feb. Standard & Poor's:

…lowered the authority's credit rating (down to 'AA+' from 'AAA') because of the Greater Vancouver Regional District (GVRD)'s increasing debt: a projected $5.5 billion by 2009.The downgrading is directly linked to expensive P3s such as the rapid transit line from the airport to downtown Vancouver (RAV) line) and the Golden Ears bridge. P3 projects result in much higher costs and less accountability for taxpayers."Early in the planning process, regional politicians were told P3s would hide debt, but accounting rules don't allow this," CUPE BC president Barry O'Neill said. "Now that debt is on the books for projects that are as much as 25 per cent over budget projections."

P3 stands for Public, Private, Partnership. Private, Profiteering, Propaganda is far more apt a name.

I encourage everyone to read as much about this subject as you can and to write to the appropriate level of government every time you hear of a P3 situation. The money you save may be your own.

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My Body, My Choice

Politics and anatomy. What do the two have to do with each other? Little. Unless of course your anatomy happens to include a womb.

Why are politicians so concerned about how, when, why or where women have sex? Why do they take upon themselves the right to legislate control over our reproduction?

I don't think it has much to do with their "faith". I don't think it is a concern for the amounts paid to welfare, or a concern for the health and well being of the female electorate, nor even a concern for the wee babes.

No I think it has to do with keeping status quo.

Control over reproduction has allowed women control over when, or if to have babies, and therefore, has raised their levels of personal and social autonomy.This autonomy has allowed women to be a great force for change. It has allowed them to enter politics, though there are still major barriers, and help advance rights for women, minorities, gays, the disabled. In short as women's rights surged forward, so too did the rights of others. Barriers were recognized and started to come down.

Women are still the front line defence of the family. It is they who tend the sick, calender the appointments, cook, clean, and because of these things they are aware of the needs not being meet by current systems.

Many women lobby for extended benefits, for healthcare, for education, a living wage, for the things that allow people to have knowledge and time to challenge the status quo. This is threatening for men who are used to being power brokers. Men who gather on golf courses to arrange deals that benefit themselves.

Is it just coincidence that the highly conservative governments of both Canada and America have brought in tax changes which require the lowest incomes to pay more while providing cuts to the highest income earners?

Tax cuts mean less revenue, less revenue means less money to spend and the first things to go are those programs which help the lower and middle classes and women in particular. Daycare and other programs which are directed toward children also suffer. Naturally without daycare women have difficulty getting work.

Many states are now bringing in bills to overturn Roe V Wade. Some do not even have provision for exemption for rape, incest or loss of life.

So if you turn to the hospital for an ectopic pregnancy you will be turned away, as to save your life would require ending the pregnancy. Hope your affairs are in order.

If a 12 year old girl finds herself pregnant by her father, she will be forced to carry that child to term.

If you are raped, you will have to bear your rapists baby, after all it isn't the baby's fault.

Of course birth control will be made cheap and easy to get right? Wrong! Viagra may be covered on drug programs but not birth control. Good girls don't have sex and if they do it is with the purpose of reproducing. Why else would the CDC be telling women to treat themselves as pre pregnant? Is it because they are preparing women for upcoming change. A change which will see women no longer in control of their reprodution but instead having it controlled by the state. Kind of like the one child policy, but in reverse.

With little access to birth control, daycare or other support systems, women will once again find themselves more controlled by their womb than their will.

Without a choice in reproduction it will be harder still for women to enter politics, to try create change, to have a say in their own lives.

America still believes firmly that ' father knows best' little wonder then that in this prevailing storm of patriarchy women's rights and freedoms are blowing in the wind. This is all backed by fundamentalist churchs of course who see it as our god given duty to both breed and obey. It is easy for them with their money from the faithful and a ready ear from politicians to lobby against human rights. It is much harder for the average woman trying to hold a job, mother her kids, keep her home in order, and still be a partner (or if single act as both partners) to lobby for them.

Studies have shown that societies which value women and in which women have a voice are more free, more egalitarian, healthier and even wealthier. It would seem like all socieites would want to strive for this. Lets not forget though that fundamentalists do not want a society where women and gays have equal rights or any rights. The ruling classes do not want any threat from the lower classes and health is seen as a commodity to buy and sell.

Power corrupt governments of various times and countries have used control of women's reproduction to further their own ends.

Whether you are left or right wing, whether you see yourself as a person of faith or not, whether you see yourself as a feminist or not, women must bond together and fight against this attack upon our person.

In America, write to your various levels of government and let them know you will not vote for anyone seeking control of your body. In Canada, write your MP and CC the leaders of all the parties.

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Father's Day

Fathers Day naturally brings memories of my father. Though he died shortly before my 8th birthday he had and still has a strong influence on my life.
Neither my mother nor my father ever treated me as a child per se. I was treated as a person who had not yet learned certain things, and my quest for knowledge was always indulged.
My father would often buy me books. I can remember how exciting it was to come downstairs to breakfast and find a book waiting there for me. To this day I have a love of books and of reading. For me one of life’s small pleasures is the smell and feel of a brand new book.
Having fought in the Second World War both my parents while having a strong sense of duty, also taught me to question those in authority.
My father felt that the only way to avoid the atrocities of the war was to keep our leaders accountable to the people at all time and in all things. In some ways I am glad he is not here to see the way the current leaders are behaving. I know that he would feel his efforts in the war had been squandered.
My father also taught me the value of truth. He would say that adherence to honesty forces you to think about your thoughts and actions. Many of those currently in power could use this valuable lesson.
Though he came from a time and place where he may well have been excused for not being so he was a great feminist. He thought sports as important for girls as for boys, he thought education a must for girls he felt it gave them a chance to see a future outside of marriage and childbearing. Not of course that he had anything against marriage or children, however he thought it wrong for young girls to see that as their only option.
I miss my father most especially on this day, the lessons he hadn’t yet taught, the stories he hadn’t yet told, most of all on this day I miss the love he gave me.

Happy Father's Day to all the dad's and especially to Mike who not only is a great dad to the four children we have together but took on a ready made family of myself and two kids and never made any difference between them.

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Support Six Nations Call for a Just and Peaceful Resolution at Caledonia

Rally!
Sat June 17th, 1-4pm.
Queen's Park, Toronto

Speakers
Drummers
Ceremony of well-being.

Bring a noisemaker.
Bring a donation of dry/canned food for the reclamation camp at
Caledonia.
Bring many people with you! Families, kids, friends, everyone.

Back the call for Canada to engage in nation-to-nation negotiations in
good faith.
Support the Six Nations non-violent stand in Caledonia against over 200
years of duplicity.


And that Saturday evening, the rally organizers invite you to their
Humanist Movement seasonal party (potluck)
Annex Art Centre, 1073 Bathurst St.
8pm.


For more info:
sisis.nativeweb.org

www.humanistmovement.ca

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Local Health Integration Networks

82% of the province has never heard of LHINs or don’t know what they are. You would think then that the province would be doing all they could to ensure that all Ontarians have a chance to learn about, and have input into this system. Perhaps even have a chance to vote on whether or not this is the direction they want their health care system to be going.

Unfortunately, the government isn’t interested in public input and is steamrolling ahead with Bill 36 regardless of the fact that few voters know what it is about, that it opens the door to privatization, that workers stand to lose their jobs, or that health care may become decidedly less accessible for many.

During a public meeting in Port Perry the chair of the Central East LHIN, Foster Loucks, said, “The health care system doesn’t belong to the LHIN board or the province, it belongs to the people and this process has to be driven from the bottom up.”[1] He also stated, “We are accessible, we want to hear from you and we need your assistance.”

These are interesting statements given that at the same meeting he mentioned that only 16% of Ontarians had any idea what the LHINs are about.

LHINs have responsibility for:

• Hospitals
• Long-term Care Homes
• Community Care Access Centres
• Community Health Centres
• Community Mental Health and Addiction Agencies
• Community Support Service Organizations (personal assistance and homemaking)

LHINs do not cover:

• Public Health
• Physicians
• Ambulance Services
• Labs

Much of this is being done to “control costs” however the two costliest items in our health care basket are pharmaceuticals and medical equipment. These costs rose from 18% to 24% of our hospital budgets in just six years. The other great factor is “wait times”. It is rare to hear anyone other than bureaucrats and those trying to privatize the system talk about wait times.

In response to what the province feels are the procedures with the greatest wait times it has created a list of five items:

§ Cataracts

§ Hip Replacement

§ Knee Replacement

§ Cancer Surgeries

§ Cardiac Procedures

These procedures will be bid on by hospitals and decisions will be made on which hospital came in with the best bid for the most procedures.

A cataract clinic has already been opened in Toronto. All cataract procedures previously done in the four large teaching hospitals are now being sent to this clinic. In all they will perform 6700 surgeries per year. Surgeries are done on an assembly line basis with 20 minutes per patient allotted.

Ontarians might well wonder why their minister of health feels comfortable sending them into an assembly line to have serious procedures performed.

There are currently three rooms open in this clinic; a fourth one has yet to be used. Is this fourth room waiting to be used by patients who can afford to pay to skip ahead?

Ontario is now offering $740 to those performing cataract surgery, Dr Allan Hudson who has been hired by the government to “study” wait times boasts, “I can tell you, you can get way below $600 on this.”

When they get “well below $600, will the patient be required to pick up the extra cost? Will support staff be cut? Will patients only get 15mins of a doctor’s time? The difference will have to come from somewhere.

Mr. McGuinty and Mr. Smitherman are quite content to allow both non and for profit clinics to take on procedures we are accustomed to having in hospital, however there is evidence that private clinics do not produce cost savings.

“The fact is, there is no evidence private clinics are more efficient or less costly," McNaught says. Recent research (CMAJ 2004;170[12]:1817-24) shows that payments for care in private for-profit hospitals in the US cost on average 19% more than in their non-profit counterparts. And, last May, the BMJ reported that surgical services contracted out to private clinics in the UK in order to reduce waiting lists cost taxpayers, on average, 40% more.[2]

Private clinics have also been shown to have higher negative outcomes and higher rates of mortality.

It is well documented that private clinics cost more and therefore will be a drain on the public health purse, forcing us to first pay through our taxes and then pay again at the source. What has not been as well documented is that this new level of bureaucracy (LHIN) does not serve as a cost cutting measure either as LHINs will drain our health care resources of $55 million dollars. This is money, which is going straight to administrative costs. That is an expensive buffer between the voter and the government, a buffer, which while promoted to serve the interests of the community, is in fact not governed by the community to any degree. LHINs do not follow political boundries neither is there anyone that the voter can hold accountable. When mistakes are made it is very convenient that the government can blame the LHINs and the populace can do nothing.

Mr. Smitherman has been quoted as saying, in regard to the current system, that, “We don’t even actually know exactly what we’re buying.” If they do not know what they are buying how can they decide they are not getting good value for their dollar?

If they do not know what they are buying then surely their system of accounting and accountability should be first to change.

Health service providers are also held hostage to the LHINs as any decisions they make are subject to a 30-day period of appeal and if the appeal is unsuccessful the decision is then final. 30 days hardly seems like a reasonable amount of time to counter such complex situations.

A quick perusal of the LHIN maps shows that they are not in fact local but cover large areas. The Central East LHIN stretches from Algonquin to Scarborough, the South West, North East and North West LHINs also cover vast distances.

You can see your LHIN area by going to this address http://www.health.gov.on.ca/transformation/lhin/lhinmap_mn.html

In a time when headlines warn us of pandemics, SARS, and other highly communicable diseases, does it make sense that we are to be forced to travel such great distances between numerous communities for health care?

Who will be footing the bill for this travel? And what about those with no car?

Does this system truly achieve integration? Experience in Britain has shown that competition among hospitals and against private clinics has led to a focus on contracts and contract performance rather than a focus on patient needs. Integration has also not occurred in regards to support staff. As each facility strives to cut costs support staff are often the first to suffer cuts and as contracts move around so do the jobs, which are offered at lower and lower rates of pay with benefits disappearing.

In the British system rates of infection have skyrocketed and the quality of hospital food has declined so badly that 10% of seriously ill patients where found to be suffering from malnutrition upon release from hospital.

Though 89% of those surveyed are against privatization the British Health Authorities continue to award contracts to private enterprise to the detriment of the health care system and those who try to access it.

HMO’s such as United Healthcare are even making their way into Britain. How long will it be before foreign interests control our health care system? With the introduction of private clinics NAFTA challenges can hardly be far behind.

Public health offices, ambulance services, labs and physicians must be part of any integrated system. How can this government even consider such changes and yet make no provision for these vitals areas to be considered? If a community hospital is turned into a long-term care facility where will people go for emergency care? What measures have been put in place to prevent spread of disease? Who will be staffing the hospitals if doctors leave to staff freestanding clinics?

Far too many questions have yet to be answered. Far too many people are still unaware of this legislation and it’s implications.

This government did not campaign on and has been given no mandate to, completely restructure the way health care is provided in this province. The rush to push this through and fact that they are backed so enthusiastically by those who wish to see two tier health care should be a warning to us all.

---

[1] http://www.axiomnews.ca/NewsArchives/2006/May/May1.htm

[2] http://www.cmaj.ca/cgi/content/full/172/2/167

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Who me?

I've been tagged by skdadl so now I must tell 8 random things about myself. Oh dear!

1. I'm very short only 5 feet tall.
2. I met Ed Broadbent at a Scottish Highland Games in Oshawa, when I was about 19, and was so shocked I couldn't utter a word.
3. I had a C-section sans anesthetic ( the epidural needle hadn't been inserted properly)
4. I love steak and beer.
5. I've always wanted to have letters after my name.
6. I love to sing, but couldn't carry a tune in a bucket.
7. I love anything creative...gardening, cooking, decorating, and someday want to be able to experiment with painting.
8. I have an unquenchable thirst for knowledge.

I tag Melissa

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LHINs

April Reign

I've been asked for more information on LHINs so I am in the process of putting together an article on Bill 36, geographic regions covered, and possible outcomes.

At this time I'm searching out legal opinions on the legislation.

Hope to have something put together in about a week. Of course it will depend on how easy it is to find information.

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Crisis In Health Care

I’ve deliberately chosen a provocative title for this article, as it is a tactic so often employed by those who are in fact causing the erosion of our single payer, universal, Medicare system.

The most recent report to come out on the Canadian system of health care delivery was published in the May 30 2006 edition of the American Journal of Public Health.

Their study showed the following;

• over 85% of Canadians have a family doctor, fewer than 80% of Americans do
• 5.1% of Canadians are unable to pay for needed medication, the US rate was double
• 13.2% of Americans had unmet health needs as compared to 10.7% of Canadians

“So it would suggest that a universal coverage system is acting to ameliorate some of the discrepancies that are otherwise found in our society.” [1]

The World Health Organization notes that the US spends 15 cents of every healthcare dollar on administration expenses, a Canadian system by contrast uses only 4 cents out of every dollar for administrative costs. If the US moved to a Canadian system their country would save $280 billion dollars a year.

Support for the current system often comes from unexpected sources, for instance, Fraser Institute economist Herb Emery says that private insurance will not reduce costs to the public system, but will reduce access for the vast majority of Canadians. The Canadian Stock Exchange strongly supports universal health care as it gives us a strong economic advantage over the US and encourages investment in Canada.

“As a former premier, Mr. Romanow understood that many arguing for private alternatives were offering the excuse that “our health care costs are eating everything else up.” But he also understood the facts, which clearly show that whether we are compared to the US or the European hybrid experiences, our Canadian single- payer model—even without the major overhaul Mr. Romanow recommended – still provides the best bang for the buck”[2]

With all this information and even large corporations such as the American auto manufactures supporting our method of health care delivery, why are so many trying to convince us otherwise?

Listening to the critics of Medicare, one soon catches on to some key words and ideas. Choice, consumer, alternatives, these are all buzzwords which try to change our thinking from health care as a right to health care as a commodity.

“This shift is evident in the ‘marketization’ of social discourse and social programs… Universities, hospitals, and clients as consumers. But, while citizens have right and duties conferred by the state-and benefits that accrue from these rights-customers have only choices that are defined by their purchasing power. This change from citizen to customer has the potential of undermining the social fabric of the community. It undermines and encourages public institutions to abandon their social obligations.”[3]

Clearly there is support for us moving towards the user pay system. Think of that 280 billion dollars mentioned earlier. There are fortunes waiting to be made and those waiting are not standing idly by. They are doing everything in their power to lobby our governments and to weaken public confidence in the current system.

In the United States the health industry spent more than $300 million dollars on lobbying in 2003, and have contributed $300 million on campaign contributions since 2000.

On the Charter Health Fund [4] website you will find this claim, “In British Columbia, health care costs now consume 43% of the total provincial budget - up from 30% in 1995. A similar situation exists across the country and the Canadian Taxpayers' Federation estimates that unless action is taken, 100% of provincial revenues will be consumed by health care within 2 to 3 decades.” These numbers appear staggering and one would think that economic collapse is imminent, however, as these figures from Ontario show these types of claims do not provide full information.

“…a closer look reveals that total program and operational spending have declined in real per capita dollars. What this means is that while health spending has stayed relatively constant over the decade studied, the rest of the provincial budget has shrunk. It is tax cuts, not health spending that is “eating up the provincial budget.”

In 1994 health care spending as a percentage of provincial revenue was 40.4%, in 2003 it had shrunk to 37.9% without the tax cuts it would have shrank dramatically to 32.5% [5]

Dr. Brian Day is president of the Charter Health Fund, he is also president elect of the Canadian Medical Association [ a vocal lobby group which represents more than 60,000 medical professionals across Canada.] and is part owner and medical director of Canada’s largest for profit medical centre.

Dr. Day was also instrumental in raising money and otherwise supporting the Chaoulli Supreme Court case. Who better then to head the CMA, which is calling for a two-tier health care system? Claiming the current system is ‘ill’ and that only by allowing doctors to opt out and wealthy patients to pay for their own care is the system going to be healed.

Britain has been working with a two tier system and this is what Michael Meacher [British Labour Party] has to say;

“There are two things wrong with this whole approach. First, it’s the wrong mode; there is no evidence that private-sector health is more efficient, cost effective or better-managed, or even that it provides net additional resources. Rather it is ideologically driven, and bought at a high price in terms of the enormous transaction costs and waste that the market has generated. What is needed instead is a genuine public-service model. That does mean tackling the delays and queues that were allowed to develop: partly by the huge extra resourcing steadily coming onstream; partly by greater internal management transparency to drive up standards; and partly by stronger local democratic involvement and a rigorous system of complaints and redress. But at the same time it means restoring the principals of comprehensiveness, universality and equity – and the professional morale that goes with them-that the market has subverted.”[6]

Britain has also been dealing with PFI’s, known as P3’s in Ontario. P3’s mean public infrastructure like roads, schools and hospitals will no longer be public institutions instead there will be for profit ownership of public infrastructure and services. Corporations finance the building and delivery of services and get paid by the public through taxes and other fees. They build it own it and we pay for it. In Britain P3’s cost 53 million pounds just for consultants, and resulted in 30% fewer hospital beds and 25% reduction in staff budgets.

P3’s mean less accountability. In a P3 hospital in Cumberland shortcuts in construction and design lead to;

• Two ceilings collapsing narrowly missing maternity patients
• A sewage system which could not cope with number of users, flooded operating theatre with sewage
• Clerical and laundry staff unable work in their offices because they are too small
• A transparent roof and no air conditioning means temperatures on sunny days can reach over 33C

In Nova Scotia P3 school deals exempt for profit owners and builders from any legal responsibility for poor construction, wiring or plumbing problems. In a Halifax P3 students and staff used bottled water for over 12 months as the for- profit owners accepted no responsibility for dealing with arsenic in the water supply. In another instance in New Brunswick students were not allowed to hang artwork on the walls or play on the grass as this might “damage the company’s asset”.

Community groups are also affected. The cost of renting a double gym in a P3 school is $75 dollars an hour, contrasted with the publicly held school gym which charges $7.50/hour for a single gym used for youth programs and $30/hour for adult groups.

Also in New Brunswick volunteer labour by parents was required when the P3 school decided it was not their responsibility to unload furniture into the school. “While public-private partnerships are often said to promote ‘the best of both worlds’, for taxpayers they have come to mean public risk for private profit.”[7]

P3’s work no better for hospitals than they do for schools. The PEI government upon realizing that the P3 hospital would cost more abandoned the idea. Brampton didn’t fare nearly as well. The William Osler Health Centre cost $174 million dollars more than if it had been built through public means, came in behind schedule and was smaller than originally planned.

Already there have been labour issues with the P3 trying to cut costs through outsourcing and reassigning of duties. While CUPE Local 146 successfully resolved that issue, it stands as evidence as to the nature of how these institutions will be run. P3’s are really just a way to backdoor privatization.

The Ontario Health Coalition [8] has run plebiscites in Hamilton, St. Catherine’s and St. Sault Marie more are planned. In all 80,000 Ontarians have voted and results from each city thus far have been overwhelmingly in favour of keeping their hospitals public.

These were the results; 97.7% in Hamilton, 98% in St. Catherine’s and 96.2% in St. Sault Marie. These figures combined with these quotes from Mr. McGuinty make one wonder why he is in fact moving ahead with these P3’s:

“We believe in public ownership and financing. I will take these hospitals and bring them inside the public sector.” (May 28^th 2003)

“I’m calling on Mr Eves to halt any contract signings when it comes to P3’s. I stand against the Americanization of our hospitals.” (Sept. 26^th 2003).

“It does not matter who delivers health care it matters that everyone can receive it.”[9]

In fact it matters greatly who delivers our health care. Under the terms of the NAFTA agreement anything other than a fully public system requires us to open the way for US based companies to compete for our health care dollars.

We must not allow the profiteers to force us into a system, which would add to our country’s debt and drastically change our way of life. We must remind our federal and provincial governments their responsibilities are to the people of this country and to its welfare.

Continuing the theme of treating patients as consumers the Ontario government is also pushing through Bill 36.[10]

“There are some significant dangers in this legislation. While it specifies how the LHINSs, Ministry and cabinet can exercise their powers to order restructuring and indemnifies them from liability for those decisions, it is short on provisions for democratic control, public input, public notice, and principals to guide this health restructuring. For those of us who support an enhanced and strengthened public non-profit healthcare system, this legislation does nothing to extend the public health system or promote non-profit health care. In fact, the legislation promotes privatization in several ways and facilitates the spread of competitive bidding through the hospital system”[11]

The government freely admits it is changing health care from a universal needs based system to one of corporation and consumer.

From the Ontario LHIN FAQ:

“When the LHIN’s are up and running, it is expected that the ministry would function more like the headquarters of a major corporation.”

Governments are not corporations. Governments have a responsibility to care for and listen to the citizens they represent.

Politicians are public servants. We are the public and we have every right to expect our government to serve our needs, not the needs of those who can spend millions of dollars on lobbyists whose objective it is to make them forget their obligation.

Appointed boards will head LHIN’s; these boards are to be hand picked by the government and answerable only to the government, not the community they serve.

When the LHIN’s are in place decisions will be made as to which hospitals can provide the most surgeries for the lowest price, the first five considerations will be:

• Cancer Surgery
• Cardiac Procedures
• Cataracts
• Hip Replacement
• Knee Replacement

In the case of the Central East LHIN the population area runs from Algonquin Park to

Scarborough. A senior in Haliburton may be forced to travel, at their own expense, from their home to a hospital in Scarborough for care. Not because it is the earliest opening, but because it is their only choice.

As contracts will be awarded on a competitive bidding basis, services may not stay at any one hospital. This will result in upheavals for all health care providers involved in your treatment. They will have to reapply for work as contracts end, and may have to relocate if their area of expertise moves to another city or town.

A January 2006, Vector Research poll showed that 82% of Ontarians know little or nothing about LHIN’s.

If the public is unaware of LHIN legislation, how are they to know that their health care may soon require more out of pocket expense? “Drugs and medical devices are key areas where new user fees may be introduced as health services are transferred out of hospitals. Patients could potentially pay for entire services out of pocket, which is permitted under the LHINs legislation (section 25.3 of the Act).”[12]

No indication has been given that the government has thought how seniors, who no

longer drive, or any patient who is without a car would travel such long distances for care. No thought seems to have been given to how follow up or emergency aftercare is that same long distance away. No thought seems to have been given to the fact that patients may now be required to have surgery and recover in a community far from home, without friends or family able to visit, and of course no thought or concern seems to have been given as to how patients are to cover these new expenses or to how these changes will affect health care providers. Although these are the initial five considerations, eventually all health care will be subject to these conditions, including maternity care.

At this point there has been talk that women will have ‘booked’ delivery dates. On those dates they will be expected to turn up at hospital to be induced or deliver by C-section. Both these procedures carry much higher risks for both mother and child. Because of the higher risk these types of deliveries require more interventions, so that cost of birth will be considerably higher and births will also be riskier. No doubt that will soon become apparent and more cost will be downloaded onto patients.

The LHIN’s obviously are not local neither are they integrated. Their umbrella does not cover;

• Physicians
• Ambulance
• Laboratories
• Independent Health Facilities
• Homes for Special Care
• Public Health
• Provincial Drug Programs

Why have these vital portions of the health care system been left out?

If the government were serious about wanting to amalgamate all areas of health care into one cohesive package it would not be leaving out these essential areas.

The government is in fact dealing solely with illness management and not with preventative structures that would actually help alleviate costs to the healthcare system by keeping us healthy to begin with.

Clean water, good housing, clear air, proper nutrition, prenatal care, access to addiction counselling, good jobs, adequate social assistance payments, all contribute to good health outcomes. Is the government putting in place legislations to deal with these important issues? As long as governments do nothing to ensure good health, health care needs will continue to rise.

As long as nothing is done about smog, asthma rates will continue to rise, as long as nothing is done about pollutants in our environment, cancers will continue to flourish, as long as nothing is done to help alleviate homelessness, diseases of poverty such as TB will continue to rise, as long as voters allow government to focus on health care costs and not the serious issues affecting our health, nothing will be done to deal with the root causes of rising health care needs.

We must fight to ensure that our voices are heard; that governments remember whom it is they serve; that health care does not go backwards to a time when want of money also meant want of service. We cannot allow our governments to disregard democracy.

Further Reading and Resources:

Ontario Health Coalition

LHINs email listserve

ohc@sympatico.ca

subject: subscribe LHINS listserve

Ontario Health Coalition

Accessibility Handbook

http://www.web.net/~ohc/docs/access.htm

Canadian Doctors for Medicare

http://www.canadiandoctorsformedicare.ca/

Speak Out Against LHIN’s

http://www.stoplhins.ca/

P3 hospitals: Murray Dobbin

http://thetyee.ca/Views/2005/10/27/HospitalBoondoggles/

Nurses open Letter to Dalton McGuinty

http://www.rnao.org/Page.asp?PageID=924&ContentID=1369

Doctors Letter to Dalton McGuinty

http://www.web.ca/ohc/P3s/docsOntPressRel.pdf

Canadian Health Coalition

http://www.healthcoalition.ca/

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[1] Dr. Tom Noseworthy, director of the University of Calgary’s Centre for Health and Policy Studies and a founding member of Canadian Doctors for Medicare.

[2] Charles E. Pascal

Romanow, Romanow, where art thou?

ISBN#1-55382-193-9

[3] John Ralston Saul, The Unconscious Civilization (1995)

[4] http://www.charterhealth.ca/

[5] Figures from Department of Finance Canada.

[6] Going Private can seriously damage your health service

By Michael Meacher British Labour Party (The Guardian Jan 12/06)

[7] Andrew Coyne, National Post columnist

[8] www.ontariohealthcoalition.ca 15 Gervais Drive, Suite 305
Toronto, Ontario M3C 1Y8

[9] Stephen Harper May 10, 2004

[10] http://www.web.ca/ohc/lhins/LHINsLegislationAnalysis2.pdf

[11] Ontario Health Coalition, Bill 36 Analysis

[12] Media Release FEBRUARY 28, 2006,

ONA, SEIU, OPSEU, CUPE

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