Democracy Gone Astray

Democracy, being a human construct, needs to be thought of as directionality rather than an object. As such, to understand it requires not so much a description of existing structures and/or other related phenomena but a declaration of intentionality.
This blog aims at creating labeled lists of published infringements of such intentionality, of points in time where democracy strays from its intended directionality. In addition to outright infringements, this blog also collects important contemporary information and/or discussions that impact our socio-political landscape.

All the posts here were published in the electronic media – main-stream as well as fringe, and maintain links to the original texts.

[NOTE: Due to changes I haven't caught on time in the blogging software, all of the 'Original Article' links were nullified between September 11, 2012 and December 11, 2012. My apologies.]

Friday, May 03, 2013

Scarborough Hospital facing more cuts, more turmoil

Already facing an internal uprising, the Scarborough Hospital has announced further cuts that staff warn will hurt patient care.

The hospital announced Thursday it is scaling back medical care in the summer and eliminating 100 staff positions on top of 98 announced earlier in the year. Seventy of the positions are for registered nurses.

The Star revealed Wednesday that the beleaguered 550-bed hospital is also planning to close 20 surgical beds and close two operating rooms. “The elimination of front-line workers will have an impact on patient care because the work still has to be done, whether it is cleaning a bed or transferring patients,” said Susan Brickell, who works as a registered nurse at the hospital and represents the Ontario Nurses’ Association.

“You are not going to have the nurses there to take care of you,” she said, adding that registered nurses are being replaced with registered practical nurses, who have fewer qualifications and are paid less. Registered practical nurses, in turn, are being replaced with personal support workers, who have even less training and are paid an even lower rate.

The turmoil at the Scarborough Hospital is representative of the “shrinking pains” being felt by the entire hospital sector in Ontario. Thursday’s provincial budget made it clear the province is downsizing the sector and pouring more resources into home care and community care.

Hospitals across the province are shrinking the size of their staff and handing out pink slips. They hope to minimize actual layoffs through attrition and buyouts.

The Scarborough Hospital had about 3,200 employees before it started the cuts in April. The elimination of positions will take that down to about 3,000.

Linda Haslam-Stroud, president of the Ontario Nurses’ Association, said there is no way patient care cannot be affected because more will be expected of those employees left behind. She cited studies that show for every patient added to the workload of a registered nurse, there is a 7 per cent increase the rate of patient death and disease.

Health Minister Deb Matthews has said that as the hospital workforce shrinks, there are growing job opportunities in the community and home care sector. But as a recent article on the online magazine HealthyDebate. ca revealed, many employees get paid less outside of the hospital sector.

The Scarborough Hospital is facing a funding shortfall that was most recently pegged at $19.6 million and is growing by $300,000 a week because of delays at implementing cuts.

The hospital has come up with 172 ways to find savings, but there has been a backlash to some of them. Plans to split birthing and surgical services between the hospital’s two sites — the General site on Lawrence Ave. E. and the Birchmount Rd. site — have been suspended so they can be studied further.

Obstetricians at the two sites have been pitted against each other and some are threatening to quit.

Some trace the problems back to the amalgamation of the two sites in 1999, arguing it never worked.

Dr. Mary Cheng, an obstetrician-gynecologist at the Birchmount campus in northern Scarborough said the maternal-newborn program at that site has suffered since the merger and is not as good as it used to be.

“This is basically a problem with north Scarborough and south Scarborough,” she argued.

“In our (maternal-newborn) program, the people from the (Birchmount) don’t work at the general site and the people from the general site don’t work at the (Birchmount) site,” she said.

“The people from the General site don’t understand the growth of the community,” Cheng continued, noting there is a substantial Chinese and Tamil community in that part of the city.

Dr. Howard Bongard, a respirologist, points the finger at the Central East Local Health Integration Network, one of 14 LHINs in Ontario that co-ordinates health services and funding for different geographic areas of the province.

The Central East LHIN covers a huge geographic area with Oshawa as the nexus and Scarborough is getting short shrift, Bongard charged. The boundaries don’t make sense, he said.

“How can Victoria Park and Bancroft, Ontario be in the same LHIN?” he asked. “We should never have been in the same LHIN.”

The Scarborough Hospital used to have a thoracic, or lung, surgeon. But because the LHIN rearranged services, Scarborough residents are now expected to go to Oshawa for lung surgery, he said.

“The expectation is that I would refer my patients to Oshawa, but I don’t. I refer them to Toronto East General. Why would people want to drive 45 minutes east to Oshawa when they can drive 15 minutes to Toronto East General?”

He went on to say there are a lot of poor immigrants in Scarborough who don’t even have cars, so it’s much easier for them to take the TTC to Toronto East General.

Bongard thinks another reason Scarborough receives poorer services is because of those demographics.

“People here are treated as second-class citizens. If this was happening in north Toronto, people would rise up and scream,” he charged.

Bongard said the administration at the Scarborough Hospital doesn’t want staff to speak out like this, but he has little to lose and is not afraid.

“I’m 65 and I don’t care anymore,” he said.

Meantime, some 340 doctors from the hospital have signed a petition sent to Matthews and the Central East LHIN, decrying changes to the surgical and birthing programs.

They say centralizing the birthing program at the Birchmount site will leave the General site short of pediatricians, a short-sighted move given that around 20 per cent of patients in the ER are children.

As well, the charge that centralizing more serious surgeries at the General site will result in long and risking delays of patients from the Birchmount site.

They are particularly fearful about plans to eventually close the emergency department at the Birchmount site.

And the doctors say plans to make the Scarborough Hospital a centre of excellence for vascular patients who have suffered strokes, ruptured aneurysms and diabetic ulcers have not materialized.

Matthews, meantime, has already rejected calls by two Liberal MPPs and even the local Liberal riding association to appoint a supervisor to take control of the hospital, saying she wants to give the incoming president a chance to tackle the many problems facing the facility.

Robert Biron takes over as president on Monday, starting almost a month earlier than planned. Biron most recently served as president of the 93-bed Northumberland Hills Hospital in Cobourg.

“I feel terrible for him. He’s walking into quicksand,” Bongard said.

Another challenge on his plate is merging programs with a third hospital in Scarborough — the Centenary site of the Rouge-Valley Health System, an idea recently floated by the LHIN.

The hospital is still struggling with the 1999 merger of the Birchmount and General sites and a proposal two years ago to merge with Toronto East General was canned after a huge community outcry.

Outgoing president Dr. John Wright said change is inevitable but that the doctors in particular don’t like it and are bucking it.

Original Article
Source: thestar.com
Author: Theresa Boyle

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