Eric Hoskins faces key test on health-care mess

Posted on October 1, 2014 in Health Debates – Opinion/Commentary – With bold steps, new Ontario health minister could succeed in reforming flawed system.
Oct 01 2014.   By: Bob Hepburn, Politics

In the days right after he was sworn in as Ontario’s health minister in June, Eric Hoskins spoke passionately about how his top priority is to improve the “patient experience” by providing better continuity of care and helping patients get treatment near to their homes.

Just last week Hoskins sent a similar message on his Twitter account in which he cited the mandate given to him by Premier Kathleen Wynne: “Continue to expand home and community care ensuring people receive care as close to home as possible.”

Hoskins deserves praise for these ambitious goals.

But he will soon need to do a lot more than merely utter some soothing words if he honestly plans to make real progress toward cleaning up Ontario’s health-care mess.

Under Hoskins’ predecessor, Deb Matthews, the province’s health system fell into disarray, with major cuts in services, most notably rehab therapy, that affected tens of thousands of patients.

At the same time, the Liberal government did nothing to curb huge pay raises for senior executives of provincial health agencies that were simultaneously enforcing a tightwad approach to home care and community care.

The chaos became so bad that the Ontario legislature authorized the auditor general earlier this year to conduct an in-depth review into how community care services are run in the province.

We will soon see just how committed Hoskins really is about tackling this deepening health system mess.

If he acts quickly and demands immediate changes in how home care, community care and rehabilitation services are funded and delivered, then patients can have some hope that Hoskins may succeed where Matthews failed.

But if he simply takes the easy way out and opts to wait until next spring when the auditor’s report is made public before deciding how — or if — to go forward, then Ontarians can safely assume they are in for more of the same inaction.

For many patients, it’s crucial that Hoskins signal his intentions soon.

Lisa Glennie is a good example of someone who is counting on Hoskins. Glennie suffered a massive stroke in November 2012, during a spinning class. She was 50 years old at the time, vibrant and busy with family and work.
I wrote about Glennie’s plight a year ago when her husband, work colleagues and friends organized a fundraiser to help defray the costs of physiotherapy sessions that OHIP refuses to fund. The second annual Lisa’s Journey of Hope fundraiser will be held Thursday night at the Corus Entertainment atrium on Queens Quay East.

Since that first fundraiser, Glennie’s health has improved slightly, but she still has extreme difficulty walking, talking and with cognitive skills. She and her husband, Roy Windhager, have been forced to sell their Scarborough home and move into an apartment. Windhager, who is a real estate agent, has drastically cut his working hours in order to care for his wife.

They are spending more than $1,000 a week for private physiotherapy, speech therapy and caregivers. Their savings are dwindling. They pay out of their own pocket for medications that would be covered if Glennie was in a hospital or long-term care facility.

All the government pays is for a personal support worker one hour each evening to help Glennie get ready for bed. Tragically, there are many evenings when the support worker fails to show up. “I don’t know if anyone will come tonight,” Windhager said in an interview.

Such cases are repeated far too often across Ontario.

Patients who leave hospitals are promised rehab therapy at home by government agencies, but in fact get nothing or very little. Instead, they must fend for themselves, often ending up stuck with massive bills for health services that the government and OHIP should be funding.

“Seems to me it’s not about the patients, but strictly a number games,” says Windhager of the provincial health-care agencies that oversee out-of-hospital services.

Michael Decter, a former Ontario deputy minister of health and now board chair of Patients Canada, a patient-focused advocacy group, says in a recent essay in the Literary Review of Canada that rising hospital costs and increasingly scarce health dollars make it a no-brainer that Ontario needs to get serious about the out-of-hospital universe. That universe includes family doctors, home care, rehab services, community pharmacy, paramedics and palliative care.

As Decter sees it, many of the elements of a robust home- and community-care system already exist, but are underfunded and often relegated to second-tier status by senior health officials.

“What is needed are passionate, visionary leaders and a willingness on the part of health care’s stewards — both financial and regulatory — to facilitate transformation, not to block it,” he says.

Is Hoskins that type of leader? Is he willing to lead the drive to transform the system?

Lisa Glennie and thousands of other patients are eager to find out.

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