How high-paid health bosses blew it
TheStar.com – Opinion/Commentary – Ontario is set to scrap controversial and bloated home-care government agencies
Nov 29 2015. By: Bob Hepburn, Politics
When high-flying politicians or senior executives come crashing down to earth it is often because their outrageous spending habits or sky-high salaries have been exposed to the public.
That’s what happened, for example, to Bev Oda in 2012 when the federal Conservative cabinet minister resigned her seat in the House of Commons after it was revealed she had ordered a $16 glass of orange juice at a London hotel and made taxpayers foot the bill.
And that’s exactly what is happening now with the pending demise of 14 huge Ontario agencies that oversee the delivery of home care to hundreds of thousands of patients each year and that employ tens of thousands of workers.
The bosses involved are the chief executive officers of the 14 Community Care Access Centres (CCACs) in Ontario. These government agencies, which have been embroiled in controversy for several years, are responsible for co-ordinating access to home and community care services, such as nursing, physiotherapy and personal support workers.
As first revealed three weeks ago by Toronto Star reporter Theresa Boyle, Health Minister Eric Hoskins is signalling that Queen’s Park will scrap the CCACs and transfer much of their duties to the province’s 14 Local Health Integration Networks (LHINs) that oversee regional health planning. Hoskins will unveil the changes in a “discussion document” to be released in the coming weeks.
For years, patients have complained that the $2.5-billion-a-year home-care system was a mess, with too much bureaucracy, a drastic shortage of funds for face-to-face care, mismanagement, lack of oversight, uneven treatment and a culture of fear. Politicians and bureaucrats at Queen’s Park, however, regularly dismissed the complaints and did little to fix the broken system.
Indeed, under former health minister Deb Matthews, the CCAC bosses were never really challenged to improve their operations. Some were openly hostile, arrogant and aggressive, operating with a sense of entitlement that saw them run their agencies as they saw fit.
But as happened to Oda, the heady days for the CCAC executives came to a sudden halt when their skyrocketing salaries and stunning pay raises were revealed. In some cases, CCAC bosses were pay raises topping $65,000 a year, with salaries over $300,000. Others saw their pay jump by more than 50 per cent over three years.
Even more revealing was the fact that while the CCAC bosses were getting massive pay raises, many of the therapists, personal support workers and nurses who actually provide care to patients were earning less than $25,000 a year and hadn’t seen a pay raise in years.
Other managers in the CCAC system also earn huge salaries. One vice president of strategy, communications and engagement earned $193,000 in 2014. In the Toronto Central CCAC, there were 45 employees earning more than $100,000 in 2014. In the Ontario Association of CCACs (OACCAC), there were 37 employees earning more than $100,000 with the executive director earning close to $300,000.
Worse was the fact that the CCAC executives were also ordering their staff, most of whom cared deeply about and worked hard to deliver good care, to trim patient services such as the number of visits to patients by front-line health workers in order to meet their budgets. Suddenly, politicians at Queen’s Park took notice.
In early 2014 an all-party legislative committee requested Auditor General Bonnie Lysyk to conduct a wide inquiry into CCAC operations. Lysyk’s report, released in September, described in detail a bloated CCAC system that costs too much money, does nothing very well and where barely 62 cents of every dollar goes to actual direct patient care. For Hoskins, that was the final straw. Now he is about to unleash the biggest change in health-care delivery in Ontario in a generation.
Through it all, the CCAC executives were often their own worst enemies. Instead of explaining why they deserved huge salaries, they became aggressive, hiring expensive lobbyists and public relations experts to promote their agencies, denouncing journalists and critics who raised legitimate concerns about the system, and misleading their own staffers on how their operations were faring or what the future might hold for them.
When news first surfaced that Hoskins was planning to dismantle the CCACs, the executives denied any real moves were coming and that their futures were in jeopardy. Some CCAC bosses went so far as to tell their staff that the Star’s articles about the pending demise of the CCACs were “inaccurate.” In recent days, though, the CCACs have gone silent as they come to grips with the realization that their jobs and agencies are likely doomed.
Hoskins is not waiting to start the transformation, but his initial timetable for dismantling the CCACs has proven to be problematic. Hoskins originally wanted the LHINs to start assuming some CCAC roles, such as responsibility for front-line staff, as early as three months from now. But sources say these timelines keep being blown up because the LHINs are not yet ready to take on increased duties.
Still, Hoskins is planning to press ahead. He will get more ammunition on Dec. 2 for the home-care transformation when Lysyk releases the second part of her inquiry into CCACs.
For patients waiting for needed treatment and who have tangled with the CCAC bureaucracy and bosses in the past, the changes can’t come soon enough.
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Tags: budget, disabilities, Health, standard of living
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