This month, in the wake of annual budget announcements from the federal and provincial governments, Canadians must face the reality that our health-care system is changing.

In early March, the Ontario Liberal government suggested that the days of increased provincial spending on health care are over — and that Dalton McGuinty now wants to see some proof of improvement in the system. His government has even suggested measures like paying hospital executives in proportion to the success of their hospitals’ treatment or patients.

In East York, we’re already getting a sneak peek of what this new health care regime could look like. This coming Thursday, Toronto East General Hospital is closing its outpatient physiotherapy clinic. A hospital manager was blunt about the reason: “This year, we will not be getting a significant increase to our budget. The $300,000 is a savings basically for us to meet our budget.”

This reverse logic of denying further provincial support in order to ensure quality has health-care workers in the system, patient and rural advocates, and others crying out in protest. But with health-care expenditures already maxed out at 46 per cent of the provincial budget, Premier McGuinty insists that it is necessary to ensure Ontario citizens get the best value from their tax dollars.

The danger is that doctors, clinics and hospitals will now feel encouraged to focus their resources on offering only a few, top-notch services at their facilities — and the variety of treatments available to Ontario residents in their local hospitals will be reduced. Private and alternative practitioners may partly close the gap, but for those who can’t afford private care, or who live outside the cities where alternatives are offered, a long trip or a long wait may be the only option.

At a public meeting to save the TEGH physiotherapy clinic on March 9, MPP Peter Tabuns encouraged attendees to write to hospital board executives and the provincial government. But as it stands, constituents are not sufficiently informed about hospital expenditures to make constructive contributions.

If hospitals provided invoices to patients at every hospital visit, they might be more in touch with the costs of public health care to hospitals and the government.

If provided with this information, residents might better understand budget cuts, and be able to contribute more valuable solutions to the discussion. Until then, pleas to the government and hospital boards can be dismissed.

Preserving health care as a social safety net in Canada will require everyone’s patience, understanding and contribution.

Canadians clearly value their health-care system. If hospitals and governments must resort to service cuts and private-sector partnerships to balance budgets, we need to get everyone on the same page: the invoice sheet. As it stands, all that patients are seeing are service cutbacks, and all that hospitals are seeing is red.

Fourteen positions have been terminated at the hospital, including lab technicians and mental health workers. Nine positions were layoffs, while the remaining five were elimination of vacancies.

This has occurred because the government isn’t giving hospitals a good idea of what their funding is going to be for next year until September , OPSEU spokesperson Rick Janson said. This shortens the length of time for hospitals to make important budgeting decisions, he said.

“Some [hospitals] are trying to avoid risk by carrying out layoffs now,” Janson said. “There haven’t been any other indications at this point in terms of what that funding level could be.”

Hospitals have been told there will be some additional funds next year but now how much.

“There will be an increase in hospital funding,” said Ivan Langrish, press secretary for health minister Deb Matthews. “But it’s a complicated process between the Ministry of Health and the Ministry of Finance to maintain quality and operating costs.”

Although these negotiations are ongoing, the parties involved have yet to reach an agreement on hospital funding.

“At this point in time we don’t have budget numbers yet,” Langrish said. “But we have made huge investments since we took office.”

Langrish said in these “challenging economic times” the ministry must consult with hospitals when designing the budget, but OPSEU is left out of the conversation.

The Rouge Valley Medical System originally planned the layoffs in 2008.

There have not been any more layoffs and there are no plans for more layoffs in the future, said David Brazeau, RVMS director of public affairs.

“A little more than three years ago we announced the deficit elimination plan,” Brazeau said. “[The layoffs are] not over and above. It’s completely consistent with what we announced in March 2008.”

The layoffs have not affected services, Brazeau said. “Patient volume has actually increased slightly since the plan began and we’ve maintained all of our services.”

The union has responded to the terminations by appealing for political support across the province.

“We had a meeting with the health minister last week to address some of these issue and we’ve left it with her,” Janson said. “[The minster] suggested that some of these layoffs could actually be rescinded, although it doesn’t look very likely when we look at the nature of a lot of layoffs.”

The union has also been contacting local MPPs.

“We’re hoping that the government will see that it doesn’t make much sense to lay off people while they’re trying to stimulate the economy and create jobs,” Janson said.

Earlier this month, teachers from the province’s 24 colleges voted in favour of continuing the school year without any stoppages.  Wednesday’s count included mail-in ballots that were received this past week.

Of about 9000 faculty members, 4473 voted to accept and 4221 voted to reject the offer, according to the Ontario Labour Relations Board.

Tyler Charlebois, director of advocacy of the College Student Alliance, said most of the terms in the agreement won’t come around until the fall.

“Faculty has received some of the things agreed upon,” Charlebois said.

Members are getting paid at an increase of 1.75 per cent. In the new semester, a modified workload will be formulated.

The final offer accepted by the teachers also includes a 5.9 per cent salary increase over the next three years.

Negotiations between the Ontario Public Service Employees Union and the colleges took over nine months.

According to Charlebois, negotiations take “way too long,” and are postponed until crunch time.

A strike would have delayed hopeful Centennial students from graduating this semester.  They would have had to complete their classes next fall.

“It’s important that students are getting the education they’re paying for in a timely fashion,” said Charlebois.

__________

College Student Alliance news release
http://www.newswire.ca/en/releases/archive/February2010/24/c4540.html

Ontario Public Service Employees Union release
http://www.opseu.org/news/press2010/feb-24-2010.htm

The organization would recruit people to register cars in their name and stage crashes, filing property damage and personal injury claim, police said.

The scheme was carried out between August and November of 2007 and brought in approximately $300,000 worth of claims, police reported.

Const. Tony Vella said the case was brought to light by police “working closely with the Insurance Bureau of Canada.”

The arrest was made on Feb. 4 after police carried out an investigation.

Maamar Saoulel, 39, is facing 11 charges relating to fraud, activities in a criminal organization and dangerous operation of a vehicle.



Williams, a decorated colonel, was recently charged with two counts of first-degree murder, two counts of forcible confinement, two break and enter charges, and two counts of sexual assault.

He attended the University of Toronto Scarborough Campus (UTSC) and graduated in late ’80s with a degree in political science and economics.

This week, any Scarborough cold cases that coincide with Williams’ studies at the campus will be examined.

“Everything’s on the table,” said homicide Det. Doug Sansom. “There’s nothing that is specifically jumping out, but any reasonable cases will be looked at.”

The investigation into Williams’ past has reminded some Scarborough residents of other incidents that occurred when Williams was attending UTSC.

Plagued by a series of murders and rapes, Scarborough was terrorized from 1984 to 1990 by an unknown attacker, nicknamed the “Scarborough Rapist”.

Bernardo, the notorious serial killer and rapist, was apprehended in 1993 and convicted in 1995 for two first-degree murders and two sexual assaults. He is alleged to have committed many more.

Police have said they are re-examining the cases that overlap with when Williams attended UTSC.

The similarities in the studies of the two men have led to speculation.

The Toronto Sun reports through a number of sources that it is possible Williams and Bernardo knew each other.

The police have stated that there is no known connection between the two men.

Bernardo also attended UTSC and graduated in the late 80’s with a degree in commerce and economics.

After graduation, Williams began his 23-year career with the Canadian Forces.

He has been posted in a number of military bases in western, eastern and central Ontario, moving up the ranks until he was promoted colonel in Jan. 2009.

The OPP have begun to examine cold cases in the areas Williams is known to have lived.

In July 2009, Williams became the commanding officer at Canadian Forces Base Trenton. He is also commander of 8 Wing.

Since then, Williams has been interviewed by media for 8 Wing’s involvement in the Haiti relief effort.

Williams will appear in court, over video up-link, on Feb. 18.

The Rouge Valley Health System gave notice on Feb. 5 of 14 positions being terminated, as part of a deficit elimination plan introduced two years ago. At Scarborough the cuts include lab technicians, mental health workers and histologists.

The layoffs could mean longer wait times for patients in histology and biopsy results could then take two to three days, which is double what is expected now, said Rick Janson, spokesperson for the Ontario Public Service Employees Union.

“It’s not exactly humane for patients to make them wait that long to find out the results of their tests,” Janson said.

The RVHS denies, however, any suggestion that service is slipping.

“In fact, we’ve improved the quality of our care,” said David Brazeau, RVHS director of public affairs.

In addition, Janson said the elimination of three social workers would cut a third of the social workers department—a substantial loss that would prolong the already four-month waitlist for children and youth mental health.

“When you consider the fight we had over mental health a couple of years ago, it’s surprising that mental health is taking another cut,” Janson said.

Brazeau said it is crucial for the health service to uphold the deficit elimination plan, so the hospital could continue operation.

“As a hospital, we’re not allowed to run in the red,” he said. “Now we’ve gotten our financial ship in order,”

Janson said the health service had promised no services would be cut as long as the hospital received at least one per cent increase in funding this year. The health ministry has not yet announced the exact increase in the hospital’s funding for this year, he said.

“It was a bit of a shock to actually see layoff notices given out,” Janson said. “We thought they would at least wait to see what their funding was going to look like.”

Brazeau said efforts are being made to secure the future of the laid-off workers, including plans for redeployment and early retirement packages for those eligible.

“It may be possible to redeploy enough people so that no one is out of work,” Brazeau said.

Aside from layoffs, the deficit elimination plan included changes in spending on the hospital’s infrastructure.

“We’ve compared ourselves to a lot of other hospitals and said, ‘Oh look, not only are they spending less money, but also getting better results,’ ” Brazeau said. “We saw that we have the talent and the determination to do better.”

College and university tuition in Ontario is a hot topic right now after the 2009 Statistics Canada report showed that Ontario’s students pay the highest fees in the country.

With the average student paying $5,951 per year for the cost of their post-secondary education — a more than 20 per cent increase since Premier Dalton McGuinty erased the tuition fee freeze in 2006 — students across the province are feeling the pinch. And the learners at East York’s college campus are no exception.

It’s not hard to find students at Centennial College’s Carlaw Avenue facility who worry about paying their bills. Kyrsten Thornhill, 24, said the price of her schooling actually leave her wondering just what is so special about the education she’s receiving.

“What’s better about the calibre of our education compared to the rest of the country,” she asked, “or [is the government] just greedy?”

Thornhill also said that she thinks one of the reasons that this is happening is because students here aren’t standing up to tuition increases.

“In Europe, like France for instance, students would be rallying in the streets against this. I think the government knows that it won’t happen here,” she said.

Alison Issac, 19, said that she is almost done her semester, and that she’s about to go on to her field placement — a placement that she says she’ll have to pay full fees for, even though she won’t be on-campus.

“I was pretty upset when I found out,” she said. Issac added that high tuition means she won’t have the money to go back to school later if she wants to — and that the costs could deter students fresh out of high school from pursuing post-secondary education at all.

“When you’re in high school, you don’t really know what you want to do, so you sign up for a program, realize you don’t like it, and then you end up getting stuck paying back a loan for something that you didn’t even want to do in the first place,” she said.

One option that the federal government is looking at to help students across the country pay back their student loans is a program called the Income Contingent Repayment plan (ICR). 

The proposal is that once students finish their post-secondary programs, the government will look at their incomes in the career they studied for — and will base their loan repayments on that.

Canadian Student Federation spokesman Hamid Osman said that the main problem with the plan is that it doesn’t take into account other factors that affect people’s everyday lives.

“It’s the worst thing possible for students and grads because it implies that whatever your job is, that’s what you can afford,” he said. With interest added into the equation, he added, “Students end up paying longer than what they could, and up to two or three times more than they should have.”

Osman also said that the ICR program would be rife with sexual discrimination because, statistically, women don’t make as much as men in our economy.

“There are pay equity issues here in Canada,” he said. “For every dollar a man makes, a woman make 76 cents. So right off the bat there is discrimination in the ICR program.”

The president of the Centennial College Student Association (CCSAI), Vishal Member, said that while he thinks the ICR program needs to be a bit more lenient, the association is doing what it can to help the college’s students deal with their debt.

“We have advocacy help and counseling. We also offer alternative repayment solutions,” he said. “How we try to approach this is we want to satisfy each and ever student at the college and try to make sure that all of their concerns will be voiced.”

Hawkins, the college’s Second Career adviser, said only 17 people had enrolled in the Ministry of Training, Colleges and Universities’ program, which offers those who qualify up to $28,000 in funding.

Second Career helps to cover the cost of retraining towards careers spanning the occupational spectrum, from flight engineer and pilot, to legal secretary or baker or butcher.

“A lot of the programs were already full or wait-listed. I think that was one thing that contributed to the numbers being a little low last year,” Hawkins said.

“Since the program was announced in June 2008, most publicly-funded colleges are already three quarters of the way through their admissions cycle and their ready to start sending out invoices.”

This school year has been dramatically different, with more than 300 students enrolled through Second Career at the Oshawa-based college. Oshawa is listed in the top 10 communities that have the most students registered for the program, most of whom come from the automotive and manufacturing industry.

The provincial government claims that since it was introduced 16 months ago, Second Career has helped over 20,000 people retrain. The province’s original expectation was to help that same amount of people in three years and has now committed an additional $78 million of funding to the program.

“As far as I’m aware, the extra $78 million being invested into the program will be used to help process existing applications that are still in the system,” Hawkins said.

Second Career often funds tuition fees according to Hawkins but any expenses after that would have to be negotiated with a counsellor at the college.

Some of the most popular programs include the school of applied sciences, skilled trades, apprenticeships and technology. Two new programs, energy auditor and renewable energy technician, were introduced this year and have proved to be very attractive to Second Career students, said Hawkins.

“”It’s allowing people to retrain and giving them to opportunity to do something they have always dreamed about doing and also retraining people for more viable and emerging careers like the renewable energy technician program,” she said.

McCarter placed blame on lack of accountability and oversight along with poor judgment on the part of former eHealth Chief Executive Officer, Sarah Kramer.

“We did not get adequate value for the billion dollars spent,” McCarter said.

He set out recommendations in the 50-page report to ensure such a system be in place and fully functioning by 2015.

Calling the initiative “worthwhile” he stated significant changes needed to be made to ensure it is developed in a more cost-effective manner.

“When we do our audits, we not only look at the dollars and cents we also look at what is going to be the impact to the services to the people in Ontario.” McCarter said.

The initial recommendation for an electronic health records database was made in 2002 and resulted in the agency known as Smart Systems for Health (SSHA) being established. In 2005, George Smitherman who was the Ontario Minister of Health at the time launched a review of the SSHA.

Although this initial investigation brought up lack of strategic planning and accountability in their report just as McCarter’s did, it also suggested that Ontario keep such an agency in order to successfully implement the electronic database.

Two years later, the database was nowhere near completion and the agency went through a period of restructuring. The SSHA was replaced by eHealth Ontario.

The amount spent on this initiative since its inception in 2002 totalled over $1 billion. Questions around the mismanagement of funds first came to light in May of this year but McCarter was initially denied access to information and his attempts were delayed on repeated occasions.

David Caplan, the Ontario health minister, resigned from his position late Tuesday, before the official release of the report and Deb Matthews was sworn in to replace him on Wednesday. He has been the only member of government to take the fall for the lack of accountability.

Tim Hudak, leader of the provincial Progressive Conservative party and Andrea Horwath, the Ontario NDP leader, called for George Smitherman’s resignation as well after the report was released. They contend that Smitherman was the minister who presided over the worst of the abuses.

EHealth’s Kramer and Dr. Alan Hudson, chairperson of eHealth, resigned in June and have not faced any criminal charges. Although Kramer was accused of obvious favouritism, McCarter maintains he did not find any evidence of fraud or criminal activity during his investigation.

“Although our staff was well aware to keep their eyes open for it, we saw no evidence that contracts were given because of what I call party politics,” McCarter said.

“My sense was that in the procurement issues where firms or individuals were getting contracts it was more based on prior relationships,” he added.

This week, the provincial government announced that solar panels will be banned from the top two tier classes of farmland (A1 and A2) except for smaller ground-mounted panel arrangements that produce 100 kilowatts of energy or less. Panels that generate up to 500 megawatts will be allowed on A3 class lands.

The president of the Canadian Solar Industries Association (CanSIA), Elizabeth McDonald, is concerned that the provincial government’s announced limitations to farmland use threaten the future of solar energy in Ontario.

McDonald said that if the province decides to halt the development of solar energy, these projects will go to other provinces or countries since “investment goes where it’s most conducive.”

But Don McCabe, the vice-president for the Ontario Federation of Agriculture (OFA) which represents approximately 37,000 farm families across the province, said that CanSIA should be looking elsewhere when it comes to solar energy development.

McCabe affirmed that his membership is not against solar power, but he said that the OFA – which represents nine in 10 farmers in Ontario – doesn’t want to see the province’s most valuable (A1 and A2) agricultural land “wasted” by energy companies.

“Why are they (CanSIA) asking for the best farmland for development?” McCabe said. “I can live a day without turning the light switch on, but I can’t live a day without eating. This is why farmland shouldn’t be taken from active production.”

McCabe said that CanSIA should develop solar energy projects on lands that are least suitable for agriculture.

Farmland in Ontario is classified for crop growth based on a variety of factors.  Land is ranked from A1, A2, etc. to A7.

Class A1 - Most suitable for crop growth

• Receives the most sunlight.
• Relatively flat, easy to develop.
• Best soil conditions for crop growth.

Class A7 – Least suitable for crop growth

• Receives the least amount of sunlight
• Roughest terrain, requires heaviest development to become viable farmland
• Poorest soil conditions for crop growth

“They (CanSIA) should develop on lands A5 through A7 because they cannot be effectively used for agriculture,” McCabe said.

McDonald argued that CanSIA is only asking for the province to allow development on 0.11 per cent of prime agricultural land. She also said that solar industry developers are not asking the government to allow development in the protected Greenbelt land.

PC energy critic John Yakabuski is skeptical of McDonald’s claims.

“We shouldn’t be using prime lands for that sort of development,” he said. “Keep in mind solar power isn’t a reliable source of energy – what if the sun isn’t shining?”

McDonald argued that allowing solar power development will give farmers the extra opportunity to monetize their lands, but Yakabuski doesn’t think solar power makes economic sense.

“The government is offering 42 cents per kilowatt hour for solar electricity,” he said. “This is almost 10 times the cost of regulated energy we get from other sources, such as nuclear. Who can afford that?”