Doug Ford is on a path to try to fix the Ontario Health Care System. The Pompous Pigeons waddle around pecking at the discussion. Feeling smug and pious, nothing they say is based in fact.
Introduction
I just finished reading an article “Doug Ford details plan to tackle surgery backlogs with private clinics: ...” (Toronto Star), and some of the statements made by so-called experts can only be put into a category as laughable.
Two Types of People in this World
There are two types of people in the world. Those that “Think, Think, Think.” They go to bed each night, getting up the next morning in the same place. I will not address the issue of self-interest. The second are those that “Think, Think, Do.” They get up in the morning in a new place.
Do What You Have Always Done
If you continue to do what you have always done, you will get what you have always got. That describes the outcome for the people who “Think, Think, Think.”
If nothing is done, the citizens will get what they have always got – a medical system that has been broken for years because of the success of the nay-sayers to block any change to the system. This intransigence has affected thousands of people and has even resulted in deaths - 986 people died in Ontario in 2019 due to no surgery space. In Canada, 11,581 people died waiting for surgery in 2020 - 2021.
Do we listen to the self-serving nay-sayers, or do we support Doug Ford in his “Think, Think, Do” moment? A lot fewer people will die with access to surgeries; isn’t that a positive outcome right from the start?
What is the Worst That Can Happen?
Acting gives a chance that there will be system change. If it is good, then yahoo. If it does not work, what is the worst that can happen? Doug Ford will wear egg on his face. But at least he is grabbing the balls and shaking them.
Let’s add to this, I have not seen any of the naysayers put forward any suggestions. Easy to “be negative and complain.” In fact, it is safe. This is not a case where safety for the nay-sayers should come first. And trying to stop a fix to such an important problem, is a disservice and disingenuous at best.
The Absolutely Stupid Category
Now, a few examples of statements that I would put into the “Absolutely Stupid” category.
One so-called expert suggested, “Complex procedures such as hip and knee joint replacement surgeries should remain connected to the hospital system to ensure continuity of care and patient safety.”
What? is the clinic just going to drop them out on the street? How would continuity of care and patient safety be compromised? Easy to say, but where is the information to back that these two issues are even worth mentioning? And, people can bring up what happened in long-term care facilities during the Pandemic - yes a national tragedy - but people die in hospitals every day too from mistakes and not getting appropriate service.
"We were neglected," says the husband young lady who died in the hospital after not receiving treatment for 7 hours.” [1]
“At Canada’s largest children’s hospital, SickKids, a four-year-old child was separated from his family and flown more than 350km for treatment of a near-fatal sepsis infection amid overcrowding.” [2]
“Sometimes you will hear stories of terrible outcomes happening in an emergency department waiting times. But what often isn’t seen is the effect of those delays,” said Carr. “The press picks up on these terrible catastrophes that happened in the waiting room. But they missed out on the morbidity of conditions that happen because of delay of care.”[3]
“North Van patient dies after two days stuck in the waiting room of an overcrowded, understaffed hospital.”[4}
How does continuity of care and patient safety improve when the patient under the present system cannot get surgery? This is a one-sided circular argument; I suggest not based upon any fact. To me, it is incredulous that “professionals” can hide behind words such as “could,” “should,” “would,” and “ensure.” If there had been some context to the magnitude of the statement, then I could possibly accept it as other than a self-interest diatribe.
How many people would experience problems if the surgeries were done outside of a hospital setting? How many people have problems with hip and knee surgeries?
It is so easy to throw stones that are not based upon fact to attempt to convince us that the world will come to an end.
Privatization of the System
The healthcare system in Canada is replete with privatization. There are private walk-in medical clinics, private testing facilities (Lifelabs is private), private eye clinics, and private imaging companies to name just a few examples.
In BC (and I think Ontario), the hospitals are run by Providence Health which bills itself as a not-for-profit company.
What is the difference between not-for-profit and private in the medical environment? Not much, more importantly, it comes down to the contractual relationship between the government and the company (private, public or not-for-profit.)
Providence Health Care is billed as:
“Providence Health Care It is a denominational affiliate of Vancouver Coastal Health and partners with the Provincial Health Services Authority and the University of British Columbia to provide services to residents of the Vancouver Coastal region and specialty services to residents across British Columbia.” (From Wikipedia)
Providence Health Car is a separate entity – whether a private company or a not-for-profit, to me, is a moot point. What difference does it make? Following is how the arrangement works, which can be applied to any relationship between the government and another entity (private or not-for-profit).
“Providence is a strategic partner with Vancouver Coastal Health Authority (“VCHA”). The formal relationship is delineated within an Affiliation Agreement signed by the respective parties on June 16, 1998. The Affiliation Agreement establishes Accountability Provisions, Operating Principles, Funding Guidelines, Dispute Mechanisms, and Termination Rights between Providence and VCHA. Providence is dependent upon the Ministry and VCHA to provide sufficient funding to continue operations, to replace equipment and complete other capital projects. Providence also operates under an agreement between the Province of BC and the Denominational Health Care Facilities Association.” (BC Health Services Website)
Special Mention as the Most Laughable
This next statement wins the award for being the most laughable made regarding Doug Ford’s action:
“But critics have warned patients could face increased pressures to pay out of their own pockets for additional products and services not covered by the provincial health insurance plan, such as higher-quality lenses than OHIP covers for cataract operations.”[1]
We highlight: “to pay out of their own pockets for additional products and services not covered by the provincial health insurance plan.”
Statistics, Damn Statistics
Here are some statistics. I have not found many for Canada – so I will assume a similarity with the USA where information is available.
Knee and Hip Replacement Surgery (2020 – 2021: Canada) – 61,400
Death due to surgery: 0.0025% / 100,000 - 153 people.
Deaths from Car accidents 5%/100,000 - 1922 people.
Weigh this against the pain and suffering of the people who cannot get surgery under the present system.
Deaths? I have not found any statistics on deaths due to cataract surgery. With Cataract Surgery, there is a less than 1% chance of going blind after surgery.
This issue of risk continually brought up by the so-called experts is not supported by facts. Yes, there are risks with anything we do, but do we stop walking down the street or driving our cars because of the risk?
Conclusion
There is nothing to show that Doug Ford’s plan will not work or will work. After many years of self-serving interests working to block any fix to the system, Doug Ford has grabbed the bull by the horns and is “Think, Think, Do.” What is the worst that could happen?
The assertions by the so-called experts are not supported by facts – time to call their bluff.
We already have many examples of private operators in the health care system – it is not an issue of the type of organization; it is the type of agreement between the government s and the organizations that define the contractual relationship – that is what we have now, and I would expect that to continue.
We need to support Doug Ford, politics aside, this issue is too important to all of us, no matter where we live in Canada.
Best wishes from all of us at:
Sustainable Circular Economy
Vancouver, Canada
Website: https://www.sustainablecirculareconomy.ca
Wayne Drury is the CEO of Sustainable Circular Economy, a boutique firm in Vancouver, Canada. Its mission is to help businesses and First Nation communities arrive at environmental solutions that are good for the people and the planet and are sustainable based upon a circular economy lens of reuse, repurpose, and recycle.
[1] The Guardian (11 01 2023). “Emergency room death highlights Canadian healthcare crisis.” https://www.theguardian.com/world/2023/jan/11/canada-healthcare-crisis-emergency-room-death (Accessed 17 01 2023) [2] Ibid.
[3] Ibid. [4] Ibid.
[5} Ibid