Saturday, February 18, 2012

Drummond: More Mike Harris than Mike Harris

February 15, 2012

As expected, the Drummond Commission has proposed the province shrink and privatize hospital services.

Drummond has recommended that health care funding be limited to 2.5% until 2017-18. This is considerably less than the 3.6% increase proposed by the Liberals not long before the election. That proposal caused the Auditor General to observe in his pre-election review of Ontario's finances that $1 billion in hospital savings would have to be made.

The main target for Drummond cuts in health care spending are hospitals.

Drummond is recycling ideas from the Harris era, when the government justified hospital cuts with the claim that they would improve care in the community. Eventually, after repeated crises, the Harris government quietly changed their policy and began funding hospitals again.

Initially, Drummond had tried to distance himself from the Harris policies, but today he only noted that the cuts would be longer than in the Harris era.

Like Harris, Drummond suggests more amalgamations of hospitals -- and more specialization by hospitals. In effect, hospital services would be moved from local communities to more distant, centralized locations -- just like Harris.

Also reminiscent of the Harris era, when the government set up the unelected Health Services Restructuring Commission (HSRC) to make unpopular hospital cuts, Drummond recommends the establishment of a Commission to guide the health care reforms. In fact the Drummond report specifically cites the HSRC model.

Everyone but Drummond seems to have regretted the incredibly expensive and ineffective restructuring of health care by the HSRC.

And, also like Harris, Drummond recommends health care privatization. The corporate sector does a better job it seems. (To see who they do a better job for, see yesterday's note.) Private, for profit clinics providing surgeries and other hospitals services through fee for service funding is one privatization initiative he is especially fond of.

Drummond goes further than Harris in one respect -- Drummond appears to conceive of hospitals only as providers of acute care. That is a long way from the reality of hospitals today (or during the Harris era). There are thousands of hospital beds that are not acute care -- providing rehabilitation services, complex continuing care, mental health care, restorative care, and long term care. There are also millions of hospital procedures provided to non-acute patients in outpatient clinics.

How far the Liberals will go down the Harris Progressive Conservative road is a good question. Health Minister Deb Matthews has already rolled on keeping health care funding at 3% (despite the election promise).

A lot will depend on how hard local communities (especially small and rural communities which have the most to lose) fight back.

Bay Street has spoken. Now we have to hear from Main Street.

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