Unionized staff at the Perth & Smiths Falls District Hospital are asking those who use the health care facility to add their voices of discontent over the announced budget cuts and their impact to local services.
Members of the Ontario Council of Hospital Unions (OCHU) will be meeting with the area health coalition Saturday to see if they can set up public meetings in Perth and Smiths Falls as early as December. The purpose of the meetings will be to inform the public of the issues and why they should be pushing the provincial government to return some of the health care premium funds back to the Perth and Smiths Falls District Hospital.
"We know they can find millions of dollars for Smiths Falls and Perth," said Michael Hurley, OCHU president.
Hurley points to Cornwall which recently received an additional $5 million when its residents reacted to the planned cuts to their service. The same is true in St. Catharines where $12 million was found and in Sudbury where an additional $8 million was provided to help balance the budget and maintain services. Residents are being encouraged to let their thoughts be known to the political system and urge all political parties to clarify their position on the cuts to health care.
Ontario hospitals have been under the gun these last 20 years. In this time the local hospital has lost 44 per cent of beds.
"You used to have a lot more beds in Perth and Smiths Falls than you do know," Hurley said.
This past March the government released its budget and austerity cuts that asked all hospitals to balance their books without exception. Early this October the Perth & Smiths Falls District Hospital announced it would be making a six per cent cut in every department to bring their budget in line with provincial requirements. Recently, the closure of 12 beds (six in Smiths Falls and six in Perth) was made public.
"We don't feel that the hospital will be able to meet the needs," Hurley added of the pressure the government is placing on hospitals. "It's got nothing to do with need, it's just got to do with saving money."
Linda Bisonette, interim president and CEO at the hospital confirmed that the budget cuts they are making now should allow the hospital to continue until 2014-15 but after that there is no guarantee that further cuts won't be needed.
"We will certainly have to examine everything," Bisonette said.
Budget allotment is given to executive staff at the hospital one year at a time, but Bisonette said they aren't expecting the provincial government to provide any funding increases in the foreseeable future.
What is expected is a change to the way rural hospitals receive their funding from a system where a pot of money was provided with the local boards deciding on its allocation, to a system where funds will be specifically ear marked for identified services based on expectations of care needs the government determines for the area.
The hospital submitted its 2013 budget to the province Oct. 29 and is hopeful they will like the measures the hospital has put in place. With an uncertain future before them, Bisonette said she is confident the hospital's core role of providing acute care service to the region won't be altered.
Hurley isn't as confident and fears for the future of the small town hospital.
"To lose six beds on a surgical unit in a community like this I think is a red flag," Hurley added. "The magnitude of down sizing in Smiths Falls worries me."
Before the six bed cuts, Smiths Falls had a total of 44 beds for its surgical, ICU and maternity wards while Perth had 56 for surgical, third floor care and ICU.
During last year's public input session for the Local Health Intergration Network (LHIN) the idea of regionalizing health care services and transferring some services from the hospital into the community came out as a key part of the LHIN survey.
“Services could change dramatically as we move ahead,” said Georgina Thompson, then board chair for the South East LHIN during an interview with the newspaper last year.
At that time the LHIN was looking at allowing the patient to decide whether they wanted to wait for service locally or travel to a hospital in the region for an earlier appointment. Hurley is concerned this approach is a slippery slope and could sound the death knell for rural hospitals in the future.
For this reason the public's voice needs to be heard. If you can't attend the upcoming public meetings please write to MPP Randy Hillier (105 Dufferin St., Unit 1, Perth, Ont., K7H 3A5) and express your thoughts. The unions are also planning a postcard and door-to-door canvassing campaign in both towns.
Later that same day, Hurley was joined by John Jackson, president of CUPE (Canadian Union of Public Employees) local 2119 and Herve Cavanagh, president of OPSEU (Ontario Public Service Employees Union) local 466, at another press conference at the Perth and Union District Library.
“We don’t accept the logic that these services are superfluous,” said Hurley.
From Hurley’s point of view, these cuts are not limited to this year and next and will likely continue on until about 2017, which could undermine the viability of one of the hospital sites.
“They look at the proximity of these two hospitals and they say, ‘You don’t need two hospitals.’ It’s all about money,” said Hurley. “We will be revisiting this every year.”
About 15 years ago, there was a similar discussion about closing down one of the two hospital sites.
“They didn’t want you to have two hospitals,” said Hurley, noting their geographic closeness, and the drive to Kingston or Ottawa. “(But) the community stood up.”
While the plan was dropped, it was not thrown out, but still remains on the government’s back burner, according to Hurley.
“I don’t think the plan has changed,” said Hurley. “They look at the map and see that you have one hospital too many. The community is being set up for the eventual closure of one of these sites. That’s my belief. The viability of a two-site hospital will be imperiled.”
However, Hurley said he would not hazard a guess as to which site, Smiths Falls or Perth, the government favoured shutting down.
In a presentation to Perth town council in October, Bisonette said that while early retirement and voluntary redundancy packages were being offered, she did not believe that there would be layoffs, something Jackson simply does not believe.
“We’re not sure if layoff notices will go out,” said Jackson. “I’m not sure how they can say this.”
“Layoffs are entirely likely,” added Hurley. “The people who are left will be picking up all the work.”
Also, with six beds set to close at both sites, if looked at proportionately, according to Hurley, it would be the equivalent 1,000-bed city hospital, cutting 120 beds.
“I think you’d see the community in uproar,” said Hurley. “We haven’t seen cuts of this magnitude in the life of this government. It’s a very significant proportion of the beds and you are not seeing cuts of that magnitude – we’re not.”
In her speech to council, Bisonette noted that modern hospitals needed less beds because some patients were there simply waiting for a spot to open up at a nursing or retirement home, and that they would free up a bed, while availing of home care.
“The people in the beds they are closing would not be able to recover at home,” said Hurley.
Even though the provincial government announced $20 million more for home care support in the March budget, Hurley pointed out that “to get into and stay in acute care, you have to be quite ill. The home care system is a sham, really. If you disclose that you have any family, you won’t get it.”
While there is a 14-hour limit on how much any one patient can get of home care, that is often limited to one hour per house visit, a half hour for an apartment visit.
“Good luck (even) getting three hours,” charged Hurley, adding that the home care industry has a high turnover rate. “The thing is a myth. It’s impossible to get. I don’t believe that that is a credible position to take. These are apples to orange.”
Cavanagh, who works as a physiotherapist at both hospital sites, said that in reading The Perth Courier/Smiths Falls Record News EMC story on Bisonette’s presentation to council, “I’m questioning some of the statements in this article.”
He noted that it was indeed rare, for example, for a recovering physiotherapy patient to be back up on their feet and out the door within two days. Cavanagh also stated that Robert Devitt, the Toronto hospital CEO who led the peer review, never met with him as a union official.
“Halfway through July I said, ‘When are we going to meet this guy?’” asked Cavanagh. “I didn’t have any say.”
Ultimately, no meeting was forthcoming, and the unions were not consulted, and did not acquiesce, to management’s plans. Even though the redundancies are being painted as “voluntary exits,” Cavanagh pointed out that, either way, “you’re getting a reduction in staff,” because those positions are not being replaced. In his own department, Cavanagh said he is seeing a reduction of 3.1 staffers, with more than 100 plus patients on the waiting list.
In an interview with the Smiths Falls Record News, Bisonette said that she wished that the union had approached her with their concerns before holding the press conferences earlier this week.
“It would’ve been more appropriate to have had those discussions before the decisions were made,” retorted Cavanagh.