Drummond strikes right tone on health care: NHS supervisor
Niagara Health System supervisor anxious to see more details
ST. CATHARINES — At first blush, Don Drummond’s report on the state of Ontario’s economy seems an echo of the kind of things Kevin Smith has been saying about the Niagara Health System — increase efficiencies, reduce cost, improve quality.
But while Smith, the provincially appointed supervisor of the NHS, praised the “stark brush strokes” Drummond used to describe the state of health care in Ontario, he said the devil will be in the details.
“What I wonder is if we have the cash flow for some of the up- front expenses ( in enacting Drummond’s recommendations) that would lead to long-term efficiency,” Smith said Wednesday afternoon. “If we have the cash flow, that is great. But if not, we need to know from the government what we can enact.”
Of Drummond’s more than 360 recommendations, more than 100 focus entirely on health care in Ontario, which at more than $40 billion annually is far and away the province’s most expensive service. Drummond predicts health care will cost Ontario more than $ 60 billion by 2017 if the system is not reformed.
His recommendations are focused on what Smith called “a fundamental culture shift” in health care both for providers and patients.
Smith praised the economics of Drummond’s report, saying the only way to ultimately reduce health-care costs is to find ways to reduce the human resources expense.
Drummond’s recommendations call for a realignment of how health services are delivered. Specifically, the report calls for some tasks that doctors and nurses currently do to be done instead by qualified — but less expensive — health care practitioners.
“I don’t think we have a shortage of doctors in Ontario, but a misalignment of work,” Smith said. “So for example, why are pharmacists doing inoculations? These are things that Drummond is looking into.”
The recommendations also call for cost savings by shifting patient care away from acutecare hospitals and into the community through home care or long-term care homes.
Providing more communitybased care has been a major talking point in health-care circles for years, but according to Drummond’s report the effort has been badly underfunded.
As a result, there isn’t the resources needed in the community and non-acute patients remain in acute- care hospital beds.
Smith said Drummond’s report is not entirely clear on how to increase community resources without spending money up-front.
“The way you can do it is to say ‘ OK, we have 20 (non-acute) patients in beds in an acute-care facility. If we got rid of those beds, you could buy something like 35 beds in the community,’” Smith said. “But you have to understand that to do that, you will be taking those 20 beds out of the acute-care facility altogether.”
Smith said this is why he will be looking to the provincial government to examine the recommendations and begin to develop a road map.
“This is something that no government has had to handle before,” Smith said.
“Do we have the public service resources and skill to manage this?”
He said t he Drummond report doesn’t contain anything that would cause him to reconsider his own developing plans to revamp the NHS, including possibly building a new hospital for southern Niagara that would replace facilities in Welland and Niagara Falls.
Smith said it is not clear yet what limits the government might place on new infrastructure. If the aim to is reduce costs and improve efficiency, a new hospital might be more effective than maintaining several older sites.