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Ok.... so we've all heard that health spending is up, right?

I was looking at the FAO (Financial Accountability Office of Ontario)'s take on expenditures......and...........ummmm

1717270819650.png


Red is less money year over year.

From: https://fao-on.org/en/ExpenditureEs...ervices and Programs>SubItems>Health Services
 
Coolibop said:
The FAO projected to spend less; below from the Economic Budget Outlook. I think i overheard in a recent podcast that the province is sitting on a pile of cash. I'm not too versed in budgets but thought I'd share:
View attachment 568785
Click to expand...
There seem to be more rumblings about an early election. Having a pile of cash to spend leading up to and including a campaign would be useful.
 
Useful to whom is a better question. I'm not certain the public benefits from any cash being held up from stressed systems.
 
On the heels of my posts above........ the Ontario government out today with a new call for non-hospital delivered CT/MRI services:

Ontario Newsroom

news.ontario.ca news.ontario.ca

In the press release above, they set a goal of getting everyone a scan within 28 days (the medically recommended worst-case for the least urgent patient). That would be something, as no Ontario government has ever achieved that.

I'm not utterly opposed to doing low-risk scanning procedures outside of hospitals, I have some greater issue w/picking off surgeries, as this can impact hospital finances, and capabilities/expertise, and also burden hospitals with only the more complex cases.

I do, have a concern there though........

1) There is an outstanding report going back years that suggests far more hospitals in Ontario should have PET Scanners, while the current has added/will add a few (notably, Barrie, Newmarket and Durham Region), there still isn't even one PET Scanner in Scarborough, none in Brampton either or in K-W. Some pretty substantial gaps.

2) Virtually every hospital, all but the very smallest really need a CT Scanner these days, its essential medicine for ascertaining whether a person is having a stroke and what kind and how to treat it.

The need for the scan is very time-sensitive and not something you want to see delayed by the need to transfer a patient to another facility. The absence of CT scanners in many smaller/rural hospitals impacts their ability to attract and retain medical staff.

Again, I think I should acknowledge this government has added additional small hospitals with CT Scanners, but there's probably another 2 dozen that need that capability.
 
Northern Light said:
I'm not utterly opposed to doing low-risk scanning procedures outside of hospitals, I have some greater issue w/picking off surgeries, as this can impact hospital finances, and capabilities/expertise, and also burden hospitals with only the more complex cases.
Click to expand...

Isn't that more a compensation problem? It seems to me we should only require procedures to be done in hospital if they require the resources of a hospital. Doing more routine procedures in a hospital rather than a clinic just to pad the budget of the hospital speaks to a problem with how hospitals are funded.
 
afransen said:
Isn't that more a compensation problem? It seems to me we should only require procedures to be done in hospital if they require the resources of a hospital. Doing more routine procedures in a hospital rather than a clinic just to pad the budget of the hospital speaks to a problem with how hospitals are funded.
Click to expand...

There are issues around critical mass efficiency. Picking off some excess procedures in Toronto is not the same as displacing them from the hospital in Bracebridge.

The other thing is ........is if things going wrong-offsite, can they mitigate on-site, or do you have to transfer to hospital.

Also, when funding per procedure is fixed, you pay for the complex cases that take twice the time, with the easy cases that take 1/2 the time. When off-site facilities poach the easy cases, the hospital budget goes in the toilet.
 
Northern Light said:
Also, when funding per procedure is fixed, you pay for the complex cases that take twice the time, with the easy cases that take 1/2 the time. When off-site facilities poach the easy cases, the hospital budget goes in the toilet.
Click to expand...
Agreed, it is an accounting problem. Not a patient care problem.
 
Northern Light said:
On the heels of my posts above........ the Ontario government out today with a new call for non-hospital delivered CT/MRI services:

Ontario Newsroom

news.ontario.ca news.ontario.ca

In the press release above, they set a goal of getting everyone a scan within 28 days (the medically recommended worst-case for the least urgent patient). That would be something, as no Ontario government has ever achieved that.

I'm not utterly opposed to doing low-risk scanning procedures outside of hospitals, I have some greater issue w/picking off surgeries, as this can impact hospital finances, and capabilities/expertise, and also burden hospitals with only the more complex cases.

I do, have a concern there though........

1) There is an outstanding report going back years that suggests far more hospitals in Ontario should have PET Scanners, while the current has added/will add a few (notably, Barrie, Newmarket and Durham Region), there still isn't even one PET Scanner in Scarborough, none in Brampton either or in K-W. Some pretty substantial gaps.

2) Virtually every hospital, all but the very smallest really need a CT Scanner these days, its essential medicine for ascertaining whether a person is having a stroke and what kind and how to treat it.

The need for the scan is very time-sensitive and not something you want to see delayed by the need to transfer a patient to another facility. The absence of CT scanners in many smaller/rural hospitals impacts their ability to attract and retain medical staff.

Again, I think I should acknowledge this government has added additional small hospitals with CT Scanners, but there's probably another 2 dozen that need that capability.
Click to expand...
I'm not philosophically opposed to off-site (read: private) imaging services. Much like labs, imaging is a diagnostic tool. I am, like you, concerned that the government would feel off-the-hook for publicly-funding imaging. The one big think that holds back public expansion of imaging is that the government will pay to operate the machines, but the upfront purchase, facilities renovation, etc. is up to the hospital, which usually means fundraising and smaller communities often don't have that capacity.
 
Northern Light said:
On the heels of my posts above........ the Ontario government out today with a new call for non-hospital delivered CT/MRI services:

Ontario Newsroom

news.ontario.ca news.ontario.ca

In the press release above, they set a goal of getting everyone a scan within 28 days (the medically recommended worst-case for the least urgent patient). That would be something, as no Ontario government has ever achieved that.

I'm not utterly opposed to doing low-risk scanning procedures outside of hospitals, I have some greater issue w/picking off surgeries, as this can impact hospital finances, and capabilities/expertise, and also burden hospitals with only the more complex cases.

I do, have a concern there though........

1) There is an outstanding report going back years that suggests far more hospitals in Ontario should have PET Scanners, while the current has added/will add a few (notably, Barrie, Newmarket and Durham Region), there still isn't even one PET Scanner in Scarborough, none in Brampton either or in K-W. Some pretty substantial gaps.

2) Virtually every hospital, all but the very smallest really need a CT Scanner these days, its essential medicine for ascertaining whether a person is having a stroke and what kind and how to treat it.

The need for the scan is very time-sensitive and not something you want to see delayed by the need to transfer a patient to another facility. The absence of CT scanners in many smaller/rural hospitals impacts their ability to attract and retain medical staff.

Again, I think I should acknowledge this government has added additional small hospitals with CT Scanners, but there's probably another 2 dozen that need that capability.
Click to expand...
Recently the company I work for has been installing more CTs in rural communities like Kincardine, Southampton and soon Haliburton.

And we installed about six PET-CT machines over the past four years, Barrie being the most recent install for us.

From what I was told, private clinics such as GNMI(we installed three new MRI machines for them) make the most money from quick simple scanning procedures. I don't mind more clinics being allowed to have MRI machines, as it might give us more business for installs.
 
lenaitch said:
I'm not philosophically opposed to off-site (read: private) imaging services. Much like labs, imaging is a diagnostic tool. I am, like you, concerned that the government would feel off-the-hook for publicly-funding imaging. The one big think that holds back public expansion of imaging is that the government will pay to operate the machines, but the upfront purchase, facilities renovation, etc. is up to the hospital, which usually means fundraising and smaller communities often don't have that capacity.
Click to expand...
My boss and I were talking to a diagnostic head at a rural hospital, and they mentioned the issue they face is lack of diagnostic operators.
 
kamira51 said:
My boss and I were talking to a diagnostic head at a rural hospital, and they mentioned the issue they face is lack of diagnostic operators.
Click to expand...

This is true, IF they have the machine in the first place.

But many smaller hospitals lack a CT entirely.

@lenaitch is on point about how Ontario does this; it approves a hospital for a diagnostic machine, and agrees, generally, to fund a minimum of 40 hours per week of operation, but the hospital is left to fundraise for the purchase.

But the above glosses over that a hospital cannot fundraise for the machine without government approval to operate it in place.
 
Last edited:
kamira51 said:
Recently the company I work for has been installing more CTs in rural communities like Kincardine, Southampton and soon Haliburton.
Click to expand...

There has been progress. No question, but many, many more are needed.

kamira51 said:
And we installed about six PET-CT machines over the past four years, Barrie being the most recent install for us.
Click to expand...

They've been added at Southlake (Newmarket) and will be coming to Lakeridge Health (Durham) shortly.

But lots of large hospitals/areas lack a PET Scanner.

In Toronto:

Michael Garron
Scarborough - Centenary, Birchmount and General
North York - General
Humber River Regional
Etobicoke General

Among others.

There are no PET Scanners in:

Niagara Region
Kitchener-Waterloo
Brampton
Vaughan
Markham

And once Lakeridge goes in; the gap there will be from Lakeridge to Kingston.

The north also has only T-Bay and Sudbury.
 
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