Smitherman Admits Liberals Have No Plan for Health Care
I've printed this news release in its entirety because I think it confirms what many of us have been thinking for some time. There is no plan. There is simply a reactionary process by which patients' concerns get media attention then a whack of money. One of the posters here outlined a nice little sequence of events that leads to this outpouring of financial compassion..usually goes like this:
1. Media latches on to a story about patients who are receiving care that seems suboptimal.
2. Money gets poured on the fire to squelch the flames sometimes immediately, sometimes later.
3. A report is promised but it usually doesn't materialize. If it does, it is usually late and without any announcement.
4. The public is distracted by the dollar signs flying about and figures all will be well.
5. Usually someone within the health care system is blamed. This can be the hospital CEO, the physicians, the cleaning staff or other.
6. In most cases, a government appointed overseer is brought in to sort things out and say more money is needed---something most people involved probably already knew but it still looks good. The fact that we are spending millions of dollars so that we can say we need to spend millions of dollars more seems to be lost on many.
7. Political optics are good for the short term and on we go........never addressing the real issue, which is the lumbering health care behemoth with an insatiable thirst for cash.
Long term plan? Ahh, the LHINs perhaps-- mind you they are still wet behind the ears and show no signs of being able to deliver on a very tall order while simultaneoulsy sparing the politicians the difficult task of telling the public that all health care cannot be "free".
Smitherman Admits Liberals Have No Plan for Health Care
The Liberals 10-year strategic report on health care is a year overdue.
(Queen’s Park – June 11, 2008) Yesterday the members of the Standing Committee on Estimates learned that the McGuinty Liberals had yet to develop and publish a 10-year strategic plan for health care; a commitment it made under the Local Health System Integration Act, 2006. According to a 2007 Ministry press release, the McGuinty Liberals promised this report would “set out a vision, priorities and strategic directions for our health care system over the next 10 years.”
“The McGuinty government has broken its own promise to produce a plan to address the gaps in Ontario’s health system,” said Witmer. “Whether it’s improving access to care, modernizing health infrastructure, shortening wait times or promoting good health, Ontario requires a long term vision. A vision the McGuinty Liberals have failed to produce.”
When confronted by PC Health Critic, Elizabeth Witmer, Smitherman said “It’s true to say, and I have to take responsibility that we haven’t hit our marks on this.” The Minister went on to suggest that the report would be published sometime in 2008, however Ministry officials refused to specify a specific date this would happen. As well, during the committee proceedings Smitherman suggested the report was held back due to the 2007 election. “I think that the difficulty that we were into, to be direct with you, was that the window last year got too close to the election,” said Smitherman.
On several occasions since 2006, George Smitherman promised to release his report in the spring of 2007. In a June 2006 letter sent to all the Chairs and CEOs of Ontario’s LHINs, Smitherman wrote, “Our government is in the process of developing a 10-Year Health System Strategic Plan to be made public next spring.” In December of that year, Smitherman told members in the Legislature that “we will develop the 10-year plan over the coming months, with an expected release date in spring of 2007.”
“The election last fall would have been the appropriate time for Ontarians to have their say,” stated Witmer. “It’s disappointing the Minister was not confident enough to bring his report forward at that time.”
Currently, the McGuinty Liberals spend 46 cents of every program dollar on health. Even without a plan, spending on health care is projected to rise to $42.4 billion next year.
“The government’s failure to deliver on their promise has left health care providers operating without a clear sense of direction. Ontarians deserve better. They deserve to know how this government intends to meet the challenges of risings costs, an aging population, overcrowded emergency departments and a shortage of health care professionals. How much longer must we wait for this government to take action and develop a long overdue plan?”
-30-
For further information contact:
Elizabeth Witmer, MPP
(416) 325-1306
Merrilee Fullerton
85 Comments
Reader Comments (85)
No political party knows where they're going...the NDP didn't, the PCs didn't, the Liberals didn't...now here we are "somewhere else"....wherever that is.
A 10 year plan when you don't know where you're going, but pretending to know, is sheer huzzpah...even Stalin had the humility to only consider 5 year plans and even they all turned out to be disasters...a 10 year plan to go in a nebulous direction can only end up as an even greater catastrophe.
And those 150 "new" health care teams?... repackaged docs, not new ones for the most part.
I'm starting to sound cynical I fear but after a certain point it's really a bit ridiculous.
To Mr. Smitherman's credit, he had the guts to admit that there is no plan. He could have blundered along with some kind of fabrication but being found out would have been worse.
Maybe the politicians have a feeling that the courts will rule in favor of allowing private care for medically necessary services in Ontario (Lindsay McCreith and Shona Holmes) and Alberta (Murray) and that any plan they develop would need to take this into consideration.
What is it that they are waiting for?
Does it really take two years to come up with some kind of long term plan after it is promised? Maybe. There are elections that get in the way.
Perhaps the problem is knowing what to start with. There is just so much to choose from and impossible to "fix" everything. The top five priorities in my books would be:
Long term care-because if you fix this there will be a direct improvement in a number of areas. Alzheimer's numbers and other dementias are going to be on the upswing.....something needs to be done about proper funding for long term care and aging at home isn't it.
Mental Health and Addiction-because if you're mentally ill, it's tough to be physically healthy. One affects the other...maybe a chicken or egg issue. But this one is a tuffy because some people just don't get well.
Diabetes-we can't ignore this one with the rapid rise in obesity rates across all ages and its effect on many systems.
Cancer Care-rising numbers and new expensive treatments coming available. Must be addressed asap.
Diagnostics-new technologies with new ability to stage and direct treatments. Without access to diagnostics, the next step of treatment is delayed or can't be done at all.
Number 5...just about anything.Depending on how you look at almost any health area, a case can be made for any of them to be a priority...I think the government has conveniently chosen areas where it has fairly simple things to measure. Not a bad way to start...but a long way to go.
But nobody asked me and only the experts know. Oh to be a fly on the wall during these political decision-making discussions.
I wonder why the Liberals even decided to promise a 10 year plan in the first place. I don't think they needed to but I suppose it sounded good.
In response to Yogi's " If you don't know where you're going, you'll end up somewhere else", I've heard said 'nothing can be fixed until it is measured' (or something like that) but ultimately we could spend a great deal of resources measuring without understanding what the end point should be...What is the positive outcome we are looking for? Is it efficiency? If it is efficiency, how do we know when maximum efficiency is achieved, or is it ever achieved?...which means more resources must be spent looking for it instead of going to patient care. Interesting conundrum.
1. Obtain money from management board.
2. Have internal meetings to determine what we want the public to have.
3. Establish expert committees composed of Minstry staff, and experts who have a vested interest in obtaining money from the Ministry.
4. Provide money on a non competition basis to those who advise the Ministry or, who announce they support the recommendations.
5. All transfers occur.
6. Press meetings to support the movement of money.
7. All happy for a while.
8. Crisis develops.Political problem develops.
9. New money flow/blame assigned/ problem resolved.
10.Back to (1).
----------------------------------------
Reminds me of Reagan's plan for the cold war. It was, - "We win, they lose."
In the interim the bread and circuses appraoch to political decision making gave us trickle down economics without results. Unless you consider the Ronnie Reagan 1972 Corvette relevant. (The amalgam of front crash bumper and rear steel chrome epitomized the approach, not complete but it sold.)
We should sympathize with the Minister for the Sysphean task before him, but I just can't bring myself to it. To paraphrase his words, "he has to take responsibility that we haven’t hit our marks on this.” My reading is that he take the hit for the team. Let the mayoralty campaign begin.
Significant because without medical technologies, diagnoses will lag, patients won't be able to access definitive treatment...flip side is that the diagnosis may in some instances indicate that more intervention is not necessary
Well, we've made it and all is well.
The Premier will stay for our third term.
Crisis is under control. Status quo will reign for at least 5 years.
The people are happy.
The budget (although shaky) is under control.
The contract is set and stable. We own the new graduates and newly minted and approved IMGs.Properly placed incentives gets what we need, and avoids public conflict.
We believe the budget can absorb at least under 20% increase in health care needs before the next election (thank goodness for taxes!).
We continue to have positives that far exceed our negatives.
The plan is good. Ontario Health Care Lite - love it or leave.
Yes, fostering mediocrity while pretending it is a quest for excellence.
If more innovation is needed, leave enough freedom in the system for more "ingenuity" to be used at the front lines. Business studies show that most often solutions come from bottom up, not from the top down.
But we are sqeezing innovation out of medicine...particularly primary care
and pretending that government organized teams are the way to go...once this gets said by an "expert" in an ivory tower somewhere it becomes gospel.
You would have thought we had learned something from the Barer-Stoddart report or even the so-called "wisdom" behind residential schools for the aboriginals which had such terrible outcome.
The "experts" don't always have the right take on things....I'd prefer more common sense and more freedom for providers to satisfy their patients in a way that works for both sides.
Of course, sandwiching government need in the middle is always the toughest part.
One question for anybody out there:
Is there a source from which I can find the rates for NPs either in Family Health Teams or other. I've asked something similar here before and believe the numbers were between 86,000 and $110,000 but I need a source.
Anybody? Thanks.
http://www.sandwichchc.org/NursePractitioner.htm
Windsor, Ontario is Canada's southernmost destination! The city's location provides excellent accessibility to 60% of the entire population of the United States and Canada. The area offers residents access to headline concerts, major sporting events, access to canadian and US shopping destinations, international airports, tourist attractions, world renowned theatre productions, restaurants and many other exciting things to see and do within Windsor, Essex County and Metro Detroit.
Full-Time Position
Salary - $85,320.00 plus Stipend (currently $2676.48)
35 hr. work week
Nurse Practitioners are entitled to 4 weeks annual paid vacation; 5 weeks after 5 years of service
Nurse Practitioners are entitled to 1.5 sick days per month
Paid Professional Development Leave
THE POLITICS OF HEALTH
Policy, Organisation, Community: changing contexts, managing relationships
Divani Caravel Hotel, Athens, Greece: 25 - 27 June 2008
Hosted by the National School of Public Health
Politics is central to decision-makers in healthcare. At its core, it is about negotiating relationships: between managers and other health professionals and between health and other sectors, between professionals and patients. In this context, politics moves far beyond questions of political party or government.
EHMA’s 2008 conference will explore the key political issues for decision-makers in health systems and suggest ways in which healthcare management can rise to the challenges of delivering healthcare in the future. We will consider how to work across professional boundaries, how to work across sectors and how to engage with policy formation.
As for the politics of health care and watching other jurisdictions, I see that Alberta is reining in its spending:
http://www.canada.com/calgaryherald/news/story.html?id=4cbabc79-0275-468c-8629-760b1f82983d
I also hear something about Japan mandating its population to get in better health in 6 months....I'm searching for the reference.
http://www.iht.com/articles/2008/06/13/asia/13fat.php
Those exceeding government limits — 33.5 inches for men and 35.4 inches for women, which are identical to thresholds established in 2005 for Japan by the International Diabetes Federation as an easy guideline for identifying health risks — and having a weight-related ailment will be given dieting guidance if after three months they do not lose weight. If necessary, those people will be steered toward further re-education after six more months.
To reach its goals of shrinking the overweight population by 10 percent over the next four years and 25 percent over the next seven years, the government will impose financial penalties on companies and local governments that fail to meet specific targets. The country's Ministry of Health argues that the campaign will keep the spread of diseases like diabetes and strokes in check.
The ministry also says that curbing widening waistlines will rein in a rapidly aging society's ballooning health care costs, one of the most serious and politically delicate problems facing Japan today. Most Japanese are covered under public health care or through their work. Anger over a plan that would make those 75 and older pay more for health care brought a parliamentary censure motion Wednesday against Prime Minister Yasuo Fukuda, the first against a prime minister in the country's postwar history.
"With the new law, Matsushita has to measure the waistlines of not only its employees but also of their families and retirees."
--------------------------
Sun, June 15, 2008
Alberta has unique opportunity to lead the country in health-care delivery
By ROY CLANCY
....cut
In a visit with the Sun editorial board this week, CMA President Dr. Brian Day urged the province to adapt a patient-focused funding model, where health institutions get paid according to the number of patients they treat, as opposed to getting a lump-sum block of funding up front.
Patients would have the ability to look at a hospital or clinic's record and choose where they want to have a procedure done, says the orthopedic surgeon who runs a private surgery facility in Vancouver.
...cut...
....a big factor in the demise of the health region system last month. Alberta Medical Association President Dr. Darryl LaBuick says the health-care system gradually became fragmented after the regional health authorities were created in the 1990s.
"It was be-coming more difficult to establish a standard of patient care across the province," says the St. Albert family doctor.
LaBuick cautions that the revamp planned by the province will only work if it puts the patient first."Our health-care system is now looked at as administration and system-focused, whereas the centre of care should actually be the patient."
...cut
I think the same column mentions something about the great economic conditions in Alberta will mean happy times for health care or something to that effect.
Putting these two articles back to back makes me wonder where the truth is. The fact that the Calgary Health area is tightening its belt means that the big spending is perhaps over in Alberta for healthcare. Maybe just posturing. Time will tell.
Personally, I'd rather go to the Athens conference and set some cheese ablaze....
OPPPPPAAAAAH!
Here is the link to the column from which eklimek has posted excerpts.
And ELB, in China bariatric surgery is very popular....rising rates of obesity there. Wouldn't be surprised to see the tummy police showing up instead of the granny police (who check for pregnancies in families where there is supposed to be only one child).
But a law to measure employees waist circumference in a democratic country like Japan? This is weird and extreme and makes me worried about what will happen here in order to preserve our system.
You can legislate smoking out of cars and out of public institutions and public places, but what does one do about food or alcohol when they have such social implications?
These laws are not strange or unusual. They are the logical extension of publicly funded medical services. We have plans in Ontario to add these type of services, which we know we improve the health of our citizens.
This is basicly human husbandry. We know what is good for you, we control the money, and we control the providers who want to get the money. Thus, guidelines will be enforced. There are plans to expand our reproductive care packages such that more earlier care is available for pregnancies thus permitting more abortions for those pregnancies which shouldn't go on for cost reasons, weight control programs will be brought in, smoking will be banned, etc.
Every citizen will have a primary care provider, they will enforce the guidelines or not get paid, and the public will conform to the goals will establish.
The plan is good - and we have money.
If this be true, we are tilting at the economic rational for eugenics.
Central determination of the value of life saving care is a prospect I do not relish.
municipalities, universities, schools, hospitals or children’s aid societies (MUSH sector) ...cut ...
"have become almost a law unto themselves," said Marin. "They have carved themselves a nice, comfortable niche, a zone of immunity against oversight."
Marin said Ontario remains the only province that doesn’t allow its ombudsman to investigate hospitals and long-term care homes.
.cut..
“How can it assume control over badly managed (hospitals and school boards) while at the same time refusing to subject them to the checks and balances that could have potentially prevented scandals from developing in the first place."
We are already there. Patients cost money and thus interfer with the effective use of tax money becuase they want more money than we have. Solution - cut care costs to those who cost more than we bring in on a population basis.
Won't happen. The hospitals are a mess of ansence accountablity. Money flows, and get spent as politically needed. We don't want a rational view of what money is being spent on. It is not there for patients care, it is there to soothe the locals. The last thing need is to permit a comparison of what hospitals are "buying" with their money. The senior management have got their happy faces on, the understaff are being trained to smile as needed to maintain employment, and the doctors are being brought under control. We don't want the retooling to be criticized.
Geez, won't these people ever learn?
Let the truth be told.
So Ontario doesn't look too bad here, but more than a million Ontarians either can't find an FP, or aren't looking:
http://www.statcan.ca/Daily/English/080618/d080618a.htm
As far as I am concerned, the EHR should be a super set of the EMR, but they simply see the EMR as local (and complete) and the EHR as global (and less complete).
http://www.medicalpost.com/medicine/reports/article.jsp?content=20080612_164456_4568
> power
> job
> Key ministers getting new roles
>
> GEORGE SMITHERMAN
>
> • The 44-year-old health minister, who is also deputy premier, moves
> to
> the new super-ministry of energy and infrastructure renewal.
>
> • At health, Smitherman, the first openly gay cabinet minister in
> Ontario
> history, revamped regional health authorities by creating local health
> integration networks, expanded family health teams, and made peace with
> doctors and nurses through lucrative contract settlements.
>
> • Also presided over the expansion of private-public partnerships to
> build
> dozens of new hospitals.
>
> • The Toronto Centre MPP was first elected in 1999 and he has been
> Premier
> Dalton McGuinty's only health minister since the Liberals took office in
> 2003.
>
> DAVID CAPLAN
>
> • The 43-year-old public infrastructure renewal minister is moving to
> the
> health ministry.
>
> • His mother, Elinor Caplan, was health minister in premier David
> Peterson's Liberal government from 1987 until 1990.
>
> • Caplan has been the only person to run the infrastructure ministry
> since
> McGuinty created it in 2003. The massive portfolio includes responsibility
> for agencies like the Liquor Control Board of Ontario and the Ontario
> Lottery and Gaming Corp. A scandal at the lottery commission over
> insiders' wins dogged him.
>
> • First elected in a 1997 by-election, the Don Valley East MPP is
> married
> to a nurse.
>
> 'Go-getter' to take over new super-ministry handling infrastructure
> and
> nuclear energy
>
> June 19, 2008
> Rob Ferguson
> In Los Angeles
> Robert Benzie
> In Toronto
>
>
> A sputtering economy and energy concerns have prompted Premier Dalton
> McGuinty to put George Smitherman in charge of Ontario's $26.3 billion
> nuclear expansion and its $60 billion upgrading of transit, roads and
> infrastructure.
>
> McGuinty is announcing a cabinet shuffle tomorrow that will see
> veteran
> MPP Gerry Phillips step down as energy minister. Smitherman, now minister
> of health, will be taking his job and the former duties of Public
> Infrastructure Renewal Minister David Caplan, government sources say.
>
> The dual role in an energy and infrastructure super-ministry will
> "shore
> up" both fields at a critical time, a senior government source told the
> Star, as opposition parties raise concerns about mounting layoffs and the
> ability to keep the lights on in Ontario.
>
> "The most direct thing the government can do to grow the economy in
> the
> short term is to make sure infrastructure projects are being built," said
> the senior government source, who spoke on condition of anonymity.
>
> "George is a driver. He's a go-getter. He'll be the person to get
> those
> projects in the ground."
>
> Smitherman likely got two portfolios because moving him to energy from
> health would have been seen as a demotion.
>
> Caplan, whose post included overseeing public-private partnerships to
> build and renovate dozens of hospitals, takes over from Smitherman in
> health – a portfolio his mother, Elinor Caplan, held from 1987 to 1990 in
> the David Peterson government.
>
> The Legislature rose for its summer recess yesterday so the new
> cabinet
> ministers won't face questions from the opposition until at least the end
> of September.
>
> In Los Angeles on a trade trip, McGuinty confirmed to the Star he will
> be
> making a major announcement tomorrow, but wouldn't tip his hand.
>
> "I will always act to ensure that I have the right people in the right
> positions so we can best serve the people of Ontario," said the premier,
> who flies back to Toronto tonight after four days in California.
>
> Smitherman will bring his hard-driving style to the new
> "super-ministry"
> of energy and infrastructure as Ontario prepares to build more nuclear
> reactors at the Darlington power plant and bolster the economy with
> transit and other projects.
>
> The high-level job swap has been brewing since mid-March when
> Phillips,
> 67, met with McGuinty and asked for a lighter workload within the next six
> months or so.
>
> "We took some time to think what that meant in terms of a bigger or
> smaller shuffle," added the source.
>
> "Dalton's instincts were, with the economy being a much more
> significant
> issue, we could take the opportunity to take one of our strongest
> ministers and create a bigger economic ministry and put him in charge."
>
> McGuinty made the final decision last weekend as party members
> gathered
> for their annual general meeting in Ottawa.
>
> Phillips announced this week that Darlington will get the new nuclear
> reactors. The next major decision – which company should build them – will
> be left to Smitherman, who is also deputy premier. A decision is to be
> made by year's end.
>
> Smitherman has also been asked to "raise the profile" of conservation
> efforts and renewable energy, said another government source.
>
> Smitherman, 44, has been health minister for five years, earning a
> reputation as a "change agent" for pushing through several major reforms,
> including tighter controls on hospital spending and establishing a system
> of measuring wait times for treatment.
>
> "It's in the government's interest we put him somewhere where he can
> refresh himself and apply those energies all over again," said the senior
> government source.
>
> Caplan, 43, has a head start as he prepares to become health minister.
> His
> wife, Leigh, is a nurse, and he has been overseeing dozens of hospital
> improvement projects.
>
> While dealing with problems last year at the Ontario Lottery and
> Gaming
> Corp., which fell under his portfolio, Caplan ably weathered media and
> opposition criticism.
>
> Smitherman's forceful style – NDP Leader Howard Hampton once branded
> him
> "Furious George" – may be what's needed to prevent a 20-year $26.3 billion
> nuclear plan from going off the rails as the government tries to meet a
> twice-broken promise to close coal-fired power plants, now pushed back to
> 2014.
>
> Sources in the energy sector greeted news of Smitherman's new posting
> with
> trepidation. A senior industry source said there is wariness about the
> mercurial Smitherman because Phillips was always calm and measured in
> meetings. The insider said senior executives at Ontario Power Generation,
> Hydro One and Bruce Power were watching the shuffle closely.
>
> Smitherman, who has been lining up support in a bid to run for mayor
> of
> Toronto in 2010, played coy when asked if he was getting a new job.
>
> "Not to the best of my knowledge."
>
> Caplan said much the same.
>
> "No, I have not (heard), nor would I want to speculate about that."
>
> At Queen's Park, sources said Phillips will remain in cabinet as an
> "éminence grise."
>
> Phillips hinted to reporters that a change in his responsibilities was
> coming.
>
> "It's a relatively heavy portfolio so I don't necessarily see myself
> in it
> longer term," he said.
>
> Phillips was chair of the management board of cabinet until moving to
> energy after last October's election. In the Liberal government of former
> premier David Peterson, he was minister of citizenship and minister of
> labour.
>
> In opposition, Phillips worked to get a public inquiry into the 1995
> Ontario Provincial Police shooting death of native protester Dudley George
> at Ipperwash.
>
> After the Liberals defeated the Progressive Conservatives in 2003, a
> judicial inquiry was called and its findings have become the template for
> the government's aboriginal affairs policies.
>
>
>
>
There are two nightmare scenarios for a civil servant: elections and cabinet shuffles because this entails the preparation of briefing books containing pages and pages of succinct background material covering every aspect of the portfolio.
Seeing that George (no matter what you thought of his style) had a pretty good handle of his portfolio, he wasn't THAT high maintenance.
This will not be the case with any new Minister...even one with a pedigree featuring hospital construction and Minister Mom (both federally and provincially).
So the bunker is probably re-activated and vacations are frantically being re-scheduled.
Please visit this website:
www.buy-a-civil-servant-a-can-of-tan.com
'cause they wont' be seeing the sun this summer.
Sorry.....
Let's sit down for our first briefing. We'll only talk about five high level issues. We'll have some materials available for you when we're done.
Our top five issues in Ontario Health Care are:
1. OMA Negotiations
(what we are going to give, what we are going to get in return)
2. Status of Hospital Accountability Agreements
(how many hospitals have signed, how many haven't signed, what the projected 2008-09 and 2009-10 deficits are)
3. Patient Safety
(how many have died from C. difficile, how many are sick from VRE and MRSA and what our plans are)
4. The clinical human resource crisis
(how many doctors, nurses, pharmacists, etc. we are short today and our plans to address the problems which won't take hold until after the next election)
5. And we have these things called LHINs...
Bunker not reactivated. The contract is done (and George will remain to assure it is a signed deal)).
As ELB pointed out, the corridors of power are gearing up for a lot of new briefing books. Fortunately, everything is under control and no changes are plan in health for 5 years.
"The contract is done (and George will remain to assure it is a signed deal))." - mfo
vs
"There is no significant progress in the negotiations." - 'OMA'
which to believe?
1. Brought lots of new money to MOHLTC and health.
2. Broke the OMA stranglehold of health planning
3. Has lead to the demise of FFS charging
4. Large numbers of polyclinics (FHT,FHG, APPs, etc) now in place
5. Procedure related specialists assigned to hospital budget control process
6. Hospitals living within budgets by CEOs and senior staff having bought into central control
7. More health care providers arriving under lessened professional college control
8. Public are happy
9. budget under control
10. Rationing and waittimes accepted as needed restrictions to care
11. LHINs created and in place to decrease heat on Minister.
George's problems:
1. Ontario accepts that new technology and drugs will be late adpoted in the province (provincail policy is to be late adopting)
2. Top down control through budgetary intimidation.
3. Health is formally a "political" issue not a care issue.
4. Public relation tactics are used to openly manipulate the public.
5. No transparent accountability.
6. Conflict of interest is rampant through the system
Bottom line - under George's tenure overall timely access to reasonable care has improved; overall timely access to high end care has declined.
And I thought the assumption was that the OMA contract was effectively signed, sealed and delivered - they're just waiting the necessary length of time to make it appear real negotiation had taken place?
We don't want to keep George from his nuclear power plant agenda, do we?
-----------------------------
http://youtube.com/watch?v=Pk7yqlTMvp8
George gets credit for all done on his watch. He's actually responsible for little because almost all of this stuff is produced and run through by consultants and bureaucrats. The "politicians" are manipluted into moving the agendas ahead of those within each Ministry.
That actually why nothing really changes - it's all so engrained into the middle and senior bureaucrats that the agenda are preset.
We are happy within the MOHLTC. It's stable, pay's good, benefits are great, and the new Minister is a pushover.
http://canadianpress.google.com/article/ALeqM5j3qPsM6EFPoa5K2Vv3vrr3MhJo9g