Frustration builds up among Canadian family doctors

Faced with an aging population requiring increasingly complex care, overwhelmed Canadian doctors are feeling more and more frustrated by their inability to properly serve their patients' health needs, a national survey of physicians reports.

In the survey of more than 20,000 doctors and doctors-in-training from across the country, 75 per cent reported that inadequate funding of the health care system and an under-supply of physicians and other health professionals, along with paperwork and bureaucracy, are curtailing the amount and level of care they want to provide patients.

While that attitude was expressed by all the specialties, it is perhaps most pronounced among family physicians, simply because of their number and the nature of their practice, said Calvin Gutkin, executive director and CEO of the College of Family Physicians of Canada.

Almost half of Canada's roughly 60,000 doctors are family practitioners, and it's usually the specialty seen most often by patients, he said.

"I think the frustration remains related to just the capacity within the family medicine community to address all of the needs of the population," said Dr. Gutkin, whose organization conducts the triennial survey jointly with the Canadian Medical Association and the Royal College of Physicians and Surgeons of Canada.

"Physicians in most communities across the country are doing their best to try to see as many patients as they can," he said.

"But still many of them have had to ... limit the number of new patients they can take. And we have community after community with patients who are unable to access a family physician for themselves or for their families. "

Read the rest of the story here

A related story about Calgary doctors can be read in here

Does Halifax get its own Mayo Clinic?

Liberal Leader Stephen McNeil's remonstrations in the legislature this month condemning a year-old memo from some Capital District Health Authority physicians proposing a new, doctor-driven, private-public, "Mayo Clinic-like" hospital facility in metro were an emblematic example of the sort of backward, stick-in-the-mud attitudes and reactionary, tunnel-vision thinking that keep Nova Scotia an underachieving backwater.

McNeil trotted out the customary boilerplate about defending the sacrosanct public health care system from the evils of profit motive or market accountability, trotting out the old FUD (Fear, Uncertainty and Doubt) about privatization of health care delivery leading to (horrors!) - two-tiered health care, with NDP leader Darrell Dexter chiming in with his labour-union constituency's pet trope about private hospitals and clinics supposedly luring doctors and nurses away from the public system.

The 2006 memo, reportedly authored and signed by Capital Health surgeon Robert Stone, lays out a concept for clinics or centres that "should not be staffed by 'unionized' personnel

It would focus on providing endoscopy; breast health services; prostate therapy; various other diagnostics; orthopedic surgery, other same-day surgeries, and executive preventive health - all procedures that do not require the facilities of a fully-equipped and staffed, acute-care surgical hospital.
For which there is a strong demand that isn't being met in a timely fashion by the current public system, and which helps keep waiting lists long for other, more complex surgeries and treatments.

It's just, plain inefficient and a misuse of scarce resources.

Read the full story here

Violence in hospitals gets out of hand

Violence seems a part of life for those working on the front lines of this country's health care system.

The impact of workplace violence on the health care industry is enormous, exacting a heavy financial toll, according to a 2006 survey by the Workers' Compensation Board of British Columbia.

Facts in figures concerning violence against health care workers:

Injury claims

Nine percent of all B.C. health care workers' accepted claims are due to violence.

More than half of the accepted B.C. claims for health care workers are from nurses aides and licensed practical nurses.

One in five of the accepted B.C. claims for healthcare workers, due to violence in the workplace, is from registered nurses.

$24-million was spent from 2002 to 2006 in workers compensation claims involving violence against health-care workers, including physicians, nurses, care aides, pharmacists, housekeeping staff, technicians and administration.

162,934 days were lost in 2006 due to accepted claims of violence against health care workers in B.C.

Fourteen B.C. health workers were injured every week in 2006, as recorded in accepted violence claims.

Most often hurt workers' body parts in attacks

Arms, including wrists, fingers and elbows: 27 percent

Backs and shoulders: 25 percent

Head, including neck, face, eyes, ears and scalp: 14 percent

Violence against nurses in Canada:

A national survey of nearly 19,000 nurses done by the Canadian Institute for Health Information, Health Canada and Statistics Canada in 2005 found the following:

29.6 Percent of nurses working in hospital said they were physically assaulted by a patient over the past 12 months

49.6 Percent of nurses who worked in a long-term care facility, such as a nursing home, said they were physically assaulted by a patient over the past 12 months

43.6 Percent of male nurses have faced physical assaults, be they in hospital, nursing homes, a community health centre or other health care settings

27.9 Percent of female nurses have faced physical assaults in the same settings

46.3 Percent of nurses working in a hospital said they were emotionally abused by a patient over the past 12 months

48 Percent of nurses working in long-term care facilities, such as nursing homes, said they were emotionally abused by a patient in the past 12 months

54.3 Percent of male nurses have reported suffering emotional abuse over the past 12 months, be it in a hospital, nursing home, a community health centre or other health-care related settings

43 Percent of female nurses have reported suffering emotional abuse in the same settings

46.7 Percent of nurses under 35 reported they have been emotionally abused by a patient in the past 12 months

38.2 Percent of nurses over 55 reported they have been emotionally abused by a patient in the past 12 months

Europeans tallest, North Americans smallest brains?

Recently, according to a study Europeans, The Dutch in particular, are now the tallest people in the World.

North Americans were always the tallest, but haven't grown since the last 25 years and are 2 inches shorter than their Dutch counterparts.

We're used to the notion of the United States as the world's dominant power, a land of untold resources, wealth and consumption.

And one reflection of this abundance is the fact that for most of the past 2 1/2 centuries, Americans have been literally the tallest people on the planet.
Feeding off the abundant wild game and rich agriculture of their vast new land, colonial Americans measured a full three inches taller than Europeans.

Not so any more.
Compared to Europeans, Americans have effectively shrunk.
Indeed, among all advanced industrial nations, Americans are now at the bottom end of the height scale.

And, no, it's not the influx of short Hispanics. The height pattern is the same for Americans even when the sample is limited to non-Hispanic, native-born Americans.

It seems to be a reflection of something more basic.
According to an influential paper in Social Science Quarterly last June by economic historians John Komlos and Benjamin Lauderdale, "height is indicative of how well the human organism thrives in its socioeconomic environment."

The relative shrinking of Americans on the world scene is perhaps then an indicator of something Americans are doing badly, not in Iraq, but right at home.

And that something should be of more than passing interest to Canadians as we continue, consciously and unconsciously, to shape our economic and social systems with the U.S. in mind.

Actually, Canada has traditionally been a blend of the U.S. and European approaches.
But in the last couple of decades, as we have focused increasingly on cutting taxes and have adopted the attitude that individuals must make it on their own in society, we've veered more closely to the U.S. model.

We tend to view the low-tax, low-spending U.S. model as simply the norm in the era of globalization. But in fact it is only the U.S. norm.

Europeans, particularly northern Europeans, have traditionally done things differently.
They have been imposing much higher taxes and delivering much more generous social programs that provide a striking array of benefits to every member of society.

Contrary to our impressions here in the West that globalization has fundamentally redesigned the world, the Europeans have stuck with their high-tax, high-spending model in the globalized era.

Read the full story here

More Canadians should get tax-incentive to start exercising

If we look at the numbers according to Obesity Canada, a network of health care professionals, as many as 25% of all teens and 50% of all adults in Canada are overweight.

A staggering 10%-12% of adult Canadians are classified as obese, putting them at serious risk of heart attack, stroke and diabetes, to name but a few of the threats they are exposed to.
The leading factors in the 'obesity epidemic' are a poor diet and inactive lifestyles.

Therefore, a New Year's resolution of the Harper government should be to get more Canadians off their couches and start exercising.
In 2007, the Tories already made a great step in the good direction with the introduction of the Children's Fitness Tax Credit, which allows parents to claim on their income tax a portion of the fees they pay to enroll their kids in sports.

The government really needs to expand the program now and include everyone over the age of 16.
Rewarding people for joining health clubs or signing up for recreational sports programs is a simple, yet effective way to get more Canadians active in our increasingly sedentary society.

Over the years, governments leaned toward using the 'stick-approach' to improving our health, but shaming and hectoring people through nagging awareness campaigns, food labelling, tobacco-use restrictions and the like will only go so far.

Now it's time to start offering rewards to people for making healthy choices.

Allowing people to claim only a portion of activity fees on their taxes will be a safeguard against abusers simply buying a gym membership as a tax write-off and then never showing up, but it will still reward people genuinely trying to get healthier.

In the long run, all Canadians will benefit.
More people leading healthy lifestyles will ease pressure on our overburdened health care system.

Source: Winnipeg Sun

Canadian girl's medication for rare disease not completely covered by health care system

Renee Stocks, a four-year-old Canadian girl from a suburb of Ottawa, was diagnosed with the medical disorder 'Glutaric Acidemia type II', also called GA II, only two-and-a-half years after the first clinical signs of her illness appeared.

The very rare disease prevents the human body from producing enzymes needed to breaking down dietary fats and proteins into forms than can easily be handled by the body.
Without these enzymes, fats and proteins build up and will cause damage to the brain, liver, lungs and kidneys.

Had Renee been tested at birth, she could have been put on a strict diet that would have reduced her chances of serious health problems later in life, according to Frank Frerman, a professor of pediatrics at the University of Colorado Health Sciences Center.

Her parents had no idea anything was wrong with her until she became seriously ill at 9 1/2 months.
She was rushed to the hospital by ambulance after vomiting and a high fever that left her slumped over in her baby seat and then spent 72 days in intensive care on life support.

“We were passed from medical service to medical service, trying to find out what was wrong with her,” Renee's mother, Ms. Stocks said.

On Renee's third birthday, following a series of tests, including organ and muscle biopsies, the family got the bad news when a hospital in Colorado confirmed that Renee had GA II.

Renee's language development was behind her peers but she has since caught up with the help of speech therapy. However, she is taught at home instead of attending junior kindergarten classes at school, because the risk of coming in contact with a sick child is too high.

The Stocks have had to refinance the family home to help pay for Renee's special diet and put other plans on hold, including a summer vacation and finishing the basement.
The high carbohydrate diet prepared by the Hospital for Sick Children in Toronto includes fake chicken fingers and macaroni and cheese.

To restrict the amount of amino acids, which Renee cannot break down, the diet adds components of protein individually.
Ms. Stocks said the federal government recently agreed to pick up the tab for the diet.

But her big worry is how the family will pay for the experimental drug Renee started taking on December 1st.
The drug, known as L-3-Hydroxybutyrate, was developed by a Belgian doctor, Johan Van Hove, who now works at the Colorado lab, and costs $200 a day.

It is known as an orphan drug because the cost is not covered by private insurance plans or the Ontario government.
It is also well beyond the reach of what her husband, Andrew, earns as a paramedic.
Local residents recently held a fund raiser for the family, raising $14,200, enough for a two-month supply of the drug.

“I'm not bitter at the government for not funding this because I understand that there has to be checks and balances in place,” Ms. Stocks said. “But it is our only hope.”

Source: Globe and Mail

Editor's opinion:

"So, why exactly is this not covered by our system, why is she not urgent?
Why does someone that smokes (by choice) and gets lung cancer, receive proper and medical help covered by the system and the parents of this innocent little girl, without ever getting a choice of being healthy, have to carry the heavy financial load for treatment of their daughter??
ANGER and DISBELIEF, are the first words that come to mind.........."

Poor people in Canada healthier than in the U.S.

Poor and less-educated Canadians are healthier than their American counterparts, according to a Kaiser health economist based in Portland.

Although overall population health is similar in both countries, there were differences at the lowest levels of income and education, said David Feeny, senior investigator at Kaiser Permanente's Center for Health Research.
He was co-author of a study that included the largest survey comparing health in the two countries.

"Income and education are well-known predictors of health status," said Feeny.
"What was surprising, however, was the statistically significant health gap between people in the U.S. and Canada at the lowest levels of income and education. The question is, what explains this gap?"

The most obvious difference between the two countries is Canada's universal health coverage, Fenny said.

"From prenatal care through death, there is no co-pay to see a family doctor or visit the hospital," he said.

"Some people think that is probably important in the differences people observe in the less advantaged. The less advantaged in the United States often have no health insurance, or inadequate insurance."

"There is an argument, not a definitive one, that with access to routine care, people seek care earlier in the progression of a disease, instead of coming in late when you've already become a complicated case."

Source: The Columbian

Statistics Canada underestimates our health care system, report says

Canadians are likely getting more value from the health care system than Statistics Canada's figures suggest, says an Ottawa-based think tank in a report criticizing the agency for shoddy estimates.

In a report to be released today and obtained by The Canadian Press, the Centre for the Study of Living Standards says Statistics Canada "may seriously underestimate" the health care system's true economic effectiveness.

It also says the agency "should devote more effort to develop better estimates of output and productivity."

"The true contribution of the health-care sector to the well-being of the Canadian population ... is not being captured in current estimates of health-care output and productivity," the report says.

Statistics Canada estimates productivity in the health care and social assistance industry fell 0.69 per cent per year from 1987-2006, the report says.

The report says that's in opposition to a 1.14 per cent increase in overall productivity in Canada during the same 20-year period.

"It is widely recognized, including by Statistics Canada officials, that these numbers may seriously underestimate the true contribution of the health-care sector to real output, and more importantly to the economic well-being of Canadians," it says.

Reached at his in-laws' house in Toronto, Andrew Sharpe, one of the authors of the report and the executive director of the centre, said the statistics agency's measurement system is flawed.

"It's an input-based measure that doesn't give you a true measure of the output of the sector," he said.

"So, there's a massive downward biased output in the health care sector in the official numbers."

The report notes several European countries and the United States are starting to measure actual output of their health care systems, and suggests Canada adopt this framework.

It suggests Statistics Canada's measurements might not fully account for improvements in the quality of health care. It notes life expectancy in Canada rose by 5.3 years from 1979 to 2004.

There will be "very different" policy implications depending on whether increased health spending stems from higher prices or improving quality, the report says.

Times&Transcript

Calgary Health Region huge deficit due to nearly 1 million hours overtime

The Calgary Health Region will post a sizable deficit this year as staffing shortages leave the medical authority with a massive bill for nearly one million hours in overtime, says the region's chief executive.

Despite earlier predictions of a balanced budget, Jack Davis, CEO of the Calgary Health Region, said the CHR will sink into the red in the '07-'08 fiscal year, due to a larger-than-expected pay hike for nurses and $63 million in overtime costs.

Davis would not reveal the anticipated size of the deficit facing the CHR, the body in charge of Calgary's health system including four hospitals. He said it will be larger than last year's $70-million shortfall, which required a government bailout.

"There's no question we'll have a deficit," Davis said in a year-end interview with the Herald.

"It's definitely going to be harder than last year."

The health authority has faced persistent problems finding enough nursing staff in recent years, which has forced local hospitals to close beds and cancel procedures.

Earlier this month, the Alberta Children's Hospital had to reschedule six surgeries in two weeks because there were not enough critical care nurses.

The CHR has faced ongoing financial pressures, largely because of Calgary's booming population and increasingly expensive medical technology.

The cash-strapped region has posted several deficits in recent years, including a $70-million shortfall last year and a $58-million deficit in 2004-05.

This year, shortages of nurses and other health workers have placed a new strain on the region's budget: overtime costs have climbed from $43.5 million last year to $63 million this year.

CHR is also picking up its share of the tab for a new contract the government signed with the province's registered nurses.

The deal, which makes Alberta's nurses the highest paid in Canada, came in higher than the CHR anticipated, leaving the region with a

$13-million unbudgeted expense.

In the past, when the CHR has run a deficit, the province has announced additional funding to help the health body remain in the black.

It is not yet clear if the government will offer the CHR additional funding to cover the deficit for the 2007-08 budget.

"Regions are required by legislation to balance their books," said Howard May, a spokesman for Alberta Health. "Those running deficits need to have a credible deficit elimination plan in place."

Laurie Blakeman, health critic for the Alberta Liberals, said the CHR could save money by hiring more nurses full time, rather than paying them time-and-a-half or double-time to work when they have a day off.

"It's penny wise and pound foolish, and we're paying the price for it," she said.

Davis said the region is already working to address the large number of part-time nurses at city hospitals and is discussing the issue with unions.

"In terms of part-time and full-time, we'll have to work with unions on something that works for everyone," said Davis.

The United Nurses of Alberta says this province has more part-time nursing jobs than any other Canadian jurisdiction.

Read the rest of the story here

Premier Nova Scotia wants to allow more private competition in health care

Rodney MacDonald, Nova Scotia's Premier, should be applauded for his openness to a greater role for private competition in health care.
In his recent state-of-the-province address, he said specifically that the provincial government was moving towards a greater role for the private sector in the delivery of publicly funded health services.

For far too long, Canada has been out of step with the rest of the industrialized world in its steadfast opposition to tapping into the competitive market for solutions to our health care woes, to the detriment of both patients and taxpayers alike.

Consider for a moment what Canadians receive in return for this steadfast commitment to the status quo.
Among the 28 developed nations that have universal health insurance programs, Canada ranks third in age-adjusted health care spending as a percentage of GDP.

At the same time, Canadians endure relatively poor access to physicians and medical technologies, while wait times for health care in Canada are not just unacceptably long but are among the longest in the developed world.
Perhaps a closer look at why other countries are getting more for less is in order.

Among the world’s 28 most developed nations that have universal health insurance coverage like Canada, the majority allow private providers to deliver publicly funded services.

All of the nations that outperform Canada across several measures of mortality related to health system performance (Australia, Sweden and Japan) employ private competitive providers in the delivery of publicly funded health care.

Allowing private hospitals to compete for the delivery of publicly funded care is a proven policy that would improve the state of Medicare for all Canadians.

Premier MacDonald’s willingness to sit down and take an honest look at those policies that have worked so well elsewhere in the developed world, bodes well for both patients and taxpayers in Nova Scotia.

Read the full story here

Canada most dangerous to the United States?

Which country is most dangerous to the United States?
This question was posed to the presidential candidates in the United States by CBS' Katie Couric last week.
Most of the candidates named Iran as the most worrisome country with Pakistan coming in a somewhat distant second place.
There was one vote for China which is not an unreasonable choice considering the quality of their exports.

"In pondering my choice, I must admit that I was heavily influenced by the recent Michael Moore movie, "Sicko." There is no question that Canada must be considered the more immediate danger to the United States...................................................."

Read what a Massachusetts' Doctor has to say about Canada and the Canadian health care system here

Health Committee Nova Scotia: "government tries to create crisis"

A recently organized citizens’ health committee in Nova Scotia, feels the government is trying to create a crisis to push for privatization by closing hospital emergency departments.

Judy Davis, spokeswoman for the North Shore Citizens’ Health Committee, said the provincial government has been creating a sense of crisis in the health care system for years, and the emergency department closures scheduled at Lillian Fraser Memorial Hospital in Tatamagouche this week is one of its methods.

“Why is the ER closing again?” asked Davis. “Despite bringing a new doctor to the area, the provincial government is failing to solve the problems.”

Health Minister Chris D’Entremont said he would much rather see committees created to look at solutions to heath care issues working through district health authorities and the Department of Health, who are well aware of issues affecting the health-care system.

“I think it is preposterous to see that kind of misunderstanding of the health- care system and exactly what happens in it,” said D’Entremont about the committee’s allegations.
“ER closures are something we’re living with. It is something that is going to happen from time to time.
“It’s an issue that is happening all across Canada not just here. But to see them try to attach it to the issue of private health care, or what have you, it is absolutely preposterous."

The minister said the department has been grappling with human health resource issues for a while and solutions are very slow in coming as people train to fill vacant positions.

“A couple locums have been located and will be in place at Lillian Fraser Memorial Hospital as of January so that will mitigate any closures that will happen there for a while,” said D’Entremont.
Davis feels one of the solutions to improve health care in Tatamagouche would be to bring a nurse practitioner to the area.

In the new year, working to establish a nurse practitioner in the community, along with keeping the emergency department at the rural hospital open, are top priorities for the local committee, organized by the Nova Scotia Citizens’ Health Care Network.

Truro Daily News

Goverment criticized about care refugee claimant Singh

Volunteers are caring for quadriplegic refugee claimant Laibar Singh 24 hours a day, but it is unclear how many of them have formal medical training, despite his supporters' assertions that he needs access to Canada's top-notch medical care.

Harjap Grewal, a spokesman for Mr. Singh and refugee advocate with No One is Illegal, said in an interview that hundreds have volunteered to care for Mr. Singh since an aneurysm left him paralyzed, but he did not provide specific numbers of formally trained people who have been tending to him.

He said that a maximum of 10 people with training as nurses or doctors have volunteered to care for Mr. Singh, but that most volunteers are not health-care professionals. They have been helping him with needs such as hygiene and going to the bathroom that he cannot handle himself.

Mr. Grewal added that Mr. Singh would not receive the treatment he needs in India because neither he nor his children can afford to pay for it.

"A lot of people have the means to make sure that he gets that care here," he said.

Harsha Walia, also with No One is Illegal, said that money for Mr. Singh's care has come through community donations. For example, Maninder Gill, owner of Radio India, has donated $5,000 toward his care.

When asked why such donations could not be used to pay for private health care in India, Mr. Singh's home country, Ms. Walia said his case is a "simple issue of justice and humanity."

"If that argument were to be made that everyone here that's in need of care just raised money and went somewhere else, it defies a basic value of human dignity," she said. "His wish is that he feels safe here. He chooses to be with his community here."

Read the rest of the story here

"His condition just deteriorates rapidly every time he's put through this game that the government's playing...................................."

GlobeAndMail

Another story from a client of our great health care system

"Here's yet another positive story, after last week's story from Mofi about the Canadian Health care system:"

"Two significant things happened to me last week. I turned 39 and I found out I need total hip replacement surgery. These are two things that I never dreamed would happen within a decade of each other, let alone a week.

I've had some issues with my right hip most of my adult life, but never imagined that I had osteoarthritis and that my hip joint was deteriorating out from under me. My dad had both his knees replaced, but that didn't happen until he was in his late 60s.

Finding out that you need this kind of surgery is a shock at first. I felt a little embarrassed to be so young and need something like this. After some research, however, I realized more and more young people are having the surgery.

Former U.S. Olympic gold-medal winning gymnast Mary Lou Retton had her hip replaced at the age of 38. And world-famous tennis champion Jimmy Connors had his hip replaced at 52. Both athletes reported being debilitated by their pain and then regaining their full quality of life after the surgery.

So, now that I am beyond the shock and embarrassment, I find myself in a state of amazement at just how far we have come in medicine and how great Canada's health system is. Had I been born in my grandmother's era, I would be facing a life of pain and the inevitability of a wheelchair. Now, just like something out of the 1970's Bionic Woman series, they tell you "we have the power to rebuild you." Maybe not better or faster than I was before, but with much less pain and much more mobility.

I know we all get frustrated with our wait times, but if we compare our system with those around the world, we have one of the best. Two things always enter my mind when I am accessing our health care system: the incredible care givers I have, and the cost of my care.

My family doctor is Dawn Edgar. She has been caring for me for about 12 years and knows everything about me, so my health care is personal and focused and I realize how lucky I am to have her.

As soon as my hip acted up she got me in to see Reginald Yabsley. He was the first orthopedic surgeon to do hip replacements in Nova Scotia. How lucky we are to have someone like him in Halifax.

His bedside manner is second to none. He has a no-nonsense, pragmatic approach that completely put me at ease. Through the entire appointment I felt informed and respected as we figured out my next move.

My feelings of comfort and joy stem not only from being in the hands of these two excellent doctors, but from not having to ask the question: How much will this cost?

I know that while I will wait for the surgery, I will be able to have it based on my need, not on what I can afford. So this holiday season I will be saying an extra prayer for all those care givers in our system who help us maintain our quality of life and for a system that is based on need, and not greed."

Candy Palmater for HFXNEWS

U.K. public health care system flops, unlike Canadian health care system

Most Canadians are proud of their public health care system.

It's paid for by everybody and used by everybody, it pools the cost of treatment and care.

Like every other health care system in the developed world it has its problems but, contrary to the claims of its enemies, it isn't in crisis.
Until recently, Britain has been like Canada.
Canada's National Health Service, despite its problems, is doing a good job and improving. But its future has been put at risk by the introduction of market forces and profit-seeking providers.

Some B.C. politicians and other private health care lobbyists are claiming that U.K. health care privatization is a success. Nothing could be further from the truth.

Britain recently introduced private hospitals, much like B.C.'s private surgical clinics, to carry out the cheap, less-risky operations on generally healthy patients.
In other words, they "cherry-pick" the profitable work and leave the NHS hospitals to care for less healthy people and all the other complex procedures.

Yet operations in these private hospitals cost on average 11 percent more than in public ones. And these profit-seeking companies are a guaranteed flow of funding.
So if their contract specifies 5,000 patients a year and only 4,500 go there, the private hospital gets paid for the full 5,000.

The former chair of the British Medical Association, James Johnson, has said, "I see hospital services destabilized as a result of over-emphasis on the use of the independent sector . . . the money could often have been better spent making greater use of existing NHS capacity."

While the incomes of private sector hospitals are guaranteed, public hospitals have been forced to compete, not just with the for-profit outfits, but with each other. To do that, the government introduced payment by results, the politicians call this "patient focused funding."

The result has been a mess. The new system was supposed to introduce fiscal discipline, but in its first year the NHS overspent its budget for the first time in 60 years. Hospitals cut back on services to clear deficits, resulting in major backlashes against the Labour party government all over the country.

The troubles don't end there.

The introduction of "patient-focused funding" and market forces has increased the proportion of the health budget spent on bureaucracy from four per cent to approximately 15 percent.

If the money is "patient focused," you have to set up and run a system that tracks both the patients and the money.

Preparing bids costs money. Lawyers and accountants have to be paid. Hospitals have to calculate, log and code each patient's costs. Then they have to send off the bills. The purchaser has to check them.

Some bills are challenged, more lawyers and accountants. And clinicians have to divert time from treating patients to tracking paperwork.

When privatization was introduced, it was presented as a solution for reducing waiting lists and costs. But in reality neither the private sector nor the "patient focused" funding are responsible for cutting the waiting lists in the U.K.

The Vancouver Sun

Editor's opinion:

"I think that governments of countries with a public health care system should keep an active eye on competition. They should impose laws on treatment in private health care facilities that compete with public facilities when the particular treatment is covered by the system."

Wait time for surgery hits all time high of over 18 weeks

A typical Canadian seeking surgical or other therapeutic treatment had to wait 18.3 weeks in 2007, an all-time high, according to new research published today by independent research organization The Fraser Institute.

“Despite government promises and the billions of dollars funneled into the Canadian health care system, the average patient waited more than 18 weeks in 2007 between seeing their family doctor and receiving the surgery or treatment they required,” said Nadeem Esmail, Director of Health System Performance Studies at The Fraser Institute and co-author of the 17th annual edition of Waiting Your Turn: Hospital Waiting Lists in Canada.

The survey measures median waiting times to document the extent to which queues for visits to specialists and for diagnostic and surgical procedures are used to control health care expenditures.

“It’s becoming clearer that Canada’s current health care system can not meet the needs of Canadians in a timely and efficient manner, unless you consider access to a waiting list timely and efficient,” Esmail added.

The 2007 survey found the total median waiting time for patients between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, increased to 18.3 weeks from 17.8 weeks observed in 2006. This is primarily due to an increase in the first wait, between seeing the general practitioner and attending a consultation with a specialist.

Total wait times increased in six provinces: Alberta, Manitoba, Ontario, Quebec, Nova Scotia, and Newfoundland. This masked the decreased wait times in British Columbia, Saskatchewan, New Brunswick and Prince Edward Island.

Total Waiting Time

Ontario recorded the shortest waiting time overall (the wait between visiting a general practitioner and receiving treatment), at 15 weeks, followed by British Columbia (19 weeks) and Quebec (19.4 weeks). Saskatchewan (27.2 weeks), New Brunswick (25.2 weeks) and Nova Scotia (24.8 weeks) recorded the longest waits in Canada.

Read the rest of the numbers here

Source: The Fraser Institute

Editor's opinion:

"If this isn't a cry for more efficiency, accountability and openness of hospital managements.........

It wouldn't hurt to have more people form "real" business life management in hospitals.

Wouldn't you like to know where all our billions of dollars end up?"

The Canadian health care system: a personal story

This is a video from Milena Tjekovska from Alberta telling about her own experience with the Canadian health care system.

Aghan bug threat: federal authorities warn hospitals

Federal authorities are warning hospitals across the country to beware of a highly drug resistant bacteria that wounded troops are bringing back from Afghanistan and that could inadvertently be spread to civilian patients.

The threat posed by the resistant strain of acinetobacter baumannii underlines the health care system's general lack of readiness for such emerging infections as they arrive in the country, said a senior Public Health Agency of Canada official.

Several soldiers being treated in civilian hospitals here have already developed pneumonia from the drug-resistant strain of the bacteria, which scientists say likely originated in the Canadian-led trauma centre at Kandahar Air Field.

Hospitals are being advised by the agency to screen injured soldiers for the bug, and take infection-control precautions if they test positive.

No transmission to non-military patients has been detected yet, and the bug is not seen as much of a danger to healthy people outside of hospital.
The fear, however, is that the resistant strain could genetically combine with more easily treatable versions of the bacteria that are more common in Canadian intensive-care units, said Shirley Paton of the public-health agency.

"We're seeing a new organism being introduced into the Canadian swamp of organisms, this one being highly resistant," she said.

"If we get someone with this highly resistant strain, are the two bugs going to get together into one? ... We're quite concerned that this will start spreading and become the acinetobacter of choice in the ICUs. We're really worried about that kind of transmission."

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