Monday, August 15, 2011

Wait lists or lobbyists?

Last week we read a report about wait times.

Where you live in Canada can make a difference in how long you wait for care

What: Wait Times in Canada—A Comparison by Province, 2011

In Ontario wait times improve, yet the media are finding individual stories of angst faced by ill patients, and their family members.
This lobby group, Ontario Health Coalition, tells us that thousands are on a waiting list.


Still Waiting: An Assessment of Ontario's Home Care System After Two Decades of Restructuring
A new report by the Ontario Health Coalition on the state of Ontario's home care system finds more than 10,000 people on wait lists for services and reveals that major problems reported by Ontario's Auditor Generals since 1998 are still not resolved. As a result, Ontario’s home care system is plagued by inadequate services, inequitable access to care and poor oversight. The report also reveals that 18,500 hospital beds have been closed since 1990 and other hospital services such as outpatient rehabilitation are being cut across Ontario. While patients are being downloaded from hospitals, too often there are inadequate services in the community.

      MEDIA RELEASE       FULL REPORT     (April 4, 2011) 

Key Findings:
  • For more than 12 years, Provincial Auditors have reported that access to home care across Ontario is inequitable with some CCACs receiving up to double the funding that others receive.
  • There are no standards for access to care. Huge wait lists have persisted for more than a decade, totalling more than 10,000 people since 1999.
  • Home care funding is decreasing as a proportion of health spending -- from 5.5% to less than 4.5% between 1999 and 2010. Funding per home care client has decreased from $3,846 in 2003 to $3,003 in 2009.
  • Inadequate standards and poor quality control have continued for more than 12 years, according to Provincial Auditors. Inconsistent and inadequate tracking of complaints has not been resolved after 12 years.
  • Public accountability and democratic control over home care have decreased.
  • Administrative costs are very high. Administration and case management take up 30% of CCAC budgets totalling more than $500 million. There are four tiers of administration before funding reaches front line care, yet oversight is consistently poor. Competitive bidding has siphoned vast resources away from care.
  • Staffing shortages threaten access to care.
  • Repeated calls by the Ontario Auditor General for a full review of the competitive bidding system in home care have been ignored.
Yet, in other news we read:

The ‘family health team' model appears to offer a solution to the problems of the chronic shortage of family doctors and the challenges of managing multiple chronic diseases new research suggests.
In an article recently published in theAnnals of Family Medicine, an Ontario doctor and his American colleague are singing the praises of the model.
In family health teams:
  • Groups of family doctors work in clinics together, alongside other health specialists.
  • The specialists are on site and include dieticians, social workers, psychologists and pharmacists.
  • The clinics are often open during evening hours and offer walk-in services on the weekends.

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