The Lucknow Sentinel, 1979-12-26, Page 11The Wingham and District
Hospital Board passed a
motion on May 16 to main-
tain 100 beds at the hospital
at all •eeStS and,if necessary,
take the province to court to
obtain the money to operate
the 14 beds declared surplus
by the ministry guideline. If
negotiation fails, the board
decided they will have no
recourse but to opt opt of
medicare and bill Ontario
direct ,-for services at the
hospital.
Deputy health minister
Allan Dyer informed the
board at a meeting in Wing -
ham on May 8 they would not
be perniitted to use the 14
surplus beds ad "floating
beds” as they, had been
• promised at a previous meet-
ing with the health minister
• Dennis Timbrell. The minist-
ry has. sal they would
convert seven beds to chronic
care which would mean an
additional $40,000 'being ad-
ded to the hospital's budget.
• The board has decided to
stand by its previouS decision
to keep open all 100 beds
because the hospital cannot
show they are needed for
• •
ospt a
OHIP
Wingham ' and District
Hospital has decided to
bypass the provincial health
care .system and has billed
01 -HP. directly - for patient
care at the hoipital for the
months of May and June.
The hospital billed01-BP
•ata 'rate of $l 10 a day: for
patients treated in the hos-
pital making a bill of about
$500,000. •
• Wingham asked OHIP for
pay within 1-5 days and
the bilis were sent in a week
ago. • -
Executive director of the
• hospital, Norman Hayes, an-
nounced the bills had been
sent to OHIP it the inaugural
session of the 1979-80 board
of goverriers of the hospital
• on June '27. •
Hayes did not know the
amount billed for outpatient
services because the type cif
services varied.
•
•
Thehospital submitted The
bills. because there is "a
need for clarification" as to
where the hospital stands in
its ,dispiite with the Ministry
f Health. T ministry
dared 18 beds surplus in
January and cut $168,000
from the hospital's global
• budget for this .y
..ear, The
hospital decided to maintain
its 82 active treatment beds
because the hospital admini-
stration and board of gover-
nors believe all the beds are
needed at the hospital.
Hayes said if they don't
get funding necessary to run
a 100 bed hospital, " it is
self-evident we are facing a
deficit' '.' •
•NOT I/4 01HP
• Hayes disagreed the hos-
pital was opting out of OHIP
because ."you can't opt out of
something you were never
in". OHIP is a payment
mechanism for the patients
who are in it he said. WS a
third party payment system
and the hospital is not in it.
"The hospital is simply
asking to be paid for services
rendered," flayertaid. ".11
ta!
•
chronic care.
Boris Milosevic, assistant
chairman of the board, told
the meeting he contacted
Liberal MPP Murray Gaunt
who has arranged a meeting '
between the Wingham Hos-
pital Board and the House
Committee Friday, May 25.
The board will negotiate with
the ministry --for the addi-
tional $142,000 required to
operate all 100 beds at the
•hospital.
If the board fails to obtain
the $142,.000 they will take.
the necessary legal steps to
test their billing for services
in the courts. The board's
solicitor, Bob Campbell, said
it comes down to whether the
province has •the right to
close •hospital beds, Hayes
said there is no provision in
the Health legislation for the
ministry to impose bed rati-
os. 11e said he does think the
health acts do force the -
•ministry to pay for patients'
hospital expenses.
The whole' basis for the
court case is being paid for
work done which is common
law said Campbell. The
hospital will have to prepare
a cost accounting system to
• determine reasonable charg-
es fot services available and
the court will oversee fair
charge for services rendered.
The only way .to •obtain
something definite from the
ministery is to take' legal
proceedings, said. Campbell:
"You must hit them where
HIP
•
•
t
Lneknow Sentbsel, We4nOilday, December 26, 1919-f,rlejige 11
it hurts," he commented. To
aveid the publicity of a court
battle with the Wingham
Hospital, Campbell believes
the government will probably
eome up with a proposal
acceptable to everyone. "We
have .a good case,3 said
Campbell.
Hayes refused to rework
the figures, of a hospital
study to show Wingham
needs 14 chronic beds to
allow the surplus beds to
remain open as chronie,beds,
because they are needed for
active treatment.
The ministry •cannot un-
derstand Wingham Hospital
sees patients who_are chronic
in nature in hospital for a few
• days at a time as active
patients said Hayes. He
implied the ministry sees
these patients as chronic
even 'though they require
active treatment while they
are in hospital.
The board decided not to
persue a Health Service Or-
, ganization because under the
ministry's concept as outlin-
ed by Dyer at the May 8
Wingham and District
Hospital has announced the
closing of 14 of its 82 active
treatment beds and the lay
off of 12 • full time staff
effective September 21.
• The hospital board unan-
imously decided to close the
beds .at a closed session
September 19 to avoid an
increasing deficit, situation.
Executive director Norman
Hayes said the hospital had
an estimated budget deficit
of more than $46,000 at the
end of August and would
face a deficit in the neigh-
bourhood of $150,000 by the
end of its fiscal year next
March. By closing the beds
•and reducing the 'staff, Mr.
Hayes estimated the total
deficit could be held to about
$50.000:
6
meeting, it is an alternative
method of closing beds.
"Only we do it ourselves,"
remarked Dr. Doug Mow-
bray.
Dr. Dick Treleaven asked
Mr. Campbell if the govern-
ment would pass "legislation
to close the beds if Wingham
won their „Ease in court.
Campbell answered the: gov-
ernment talked of legislation
when they were trying to
close Doctors' Hospital in
Toronto but they never took
it to the legislature.,
Treleaven remarked the
reason was political because
Doctors' liciSpital •is in
riding the government won
by a very small margin in the
• last election.
Dr. Treleaven warned the
board the -province will fight
with all the assets and
resources they've got. They
let Clinton Hospital stay
open because it did not mean
that much but Wingham is a
different case he said. It will
mean every hospital in the
province (will use Wingham
:...ase as a precedent).
ito.101-:(*.e$°, beds
omic loss te the communities
in an area where employ-
ment is difficult to find.
The board promised to
continue to press for restora-
tion of both beds and jobs
through court action.
Emergencies will continue
to be dealt with immediately;
but elective surgery will be
-placed on waiting lists ac-
cording to priority.
To accommodate the bed
• closures, the pediatrics ward,
has been moved to the
second floor and the number
of chrenic care beds has been
increased to 25 from 18.
The 12 staffmembers hive -
been placed on indefinite
• layoff which means,. should a
• part •time position become
available, they will have the •
first opportunity to apply for
In a press release follow- • .
refuses. ing the board's closed ses-
•
sion, .the board said it
deplores the reduction in
• to pay service to those cared for, the • • •
those al o an t e econ-
th'e position. The layoffs
were not directed at one
sector of hospital staff but
rather across the various
types of positions.
Six months ago the hospit-
al board voted to resist
closure of a single bed by
every means at its disposal.
The cutbacks were announc-
ed five months after Mr:
Hays assured the board and
members of the Citizens'
Acticin Committee there
would be no layoffs or reduc-
tion of services at the hospit-
al this year.
At that time, Mr. Hayes
reported .the. Ontario Health
• Ministry had premised ade-
quate funding to allow the,
hospital to continue operat-
• ing 100 beds for at least
another year. The ministry
subsequently denied this and •
funding was not restored,
Recently, the'ministry re-
peated its offer, td let the
hospital convert seven of the
14 active treatment beds
scheduled for closure to
chronic care -and added more
than $54,000 to the budget.
The board.accepted the offer,
but the deficit was so huge,
the board decided to close
the I4 beds.
The hospital is now in line
with the ministry formula of
3.5 active treatment beds per
thousand of referral popuia-
flan, which it had been order-
ed to meet -by next year. .
Active treatment beds haye
been reduced from SI to. 61
• and chronic beds have been
'increased from 18 toJ25.
decides not
pergue le al action
Hospital boa -rd
'
. • hardship to the families "f to
The Ontario Hospital In-
surance Plan has notified
• Wingham and District Hos-
• pital it refuses to pay bills
submitted by the hospital for
services rendered during
May and June. Hospital ad,
ministrator, Norman Hayes,
• said OHIP has acknowledged
receipt of the hills but has
declined to pay them.
• The board has retained
Toronto lawyer, Warren Sey-
fert, to handle its case to
avoid bed closures against
Ontario Ministry of Health.
• Mr. Seyfert is a member of ,
thelaw ,firrn that handled the
• case for Doctor's Hospital in
Toronto when it was threat-
ened with.closure three years
ago. The Ministry subse-
quently dropped plans to
dose that hospital.
Hospital board. chairman,
Boris Milosevic, said Mon-
day Mr. Seyfert is still In the
• process of assessing • the
• board ' s case and will inform
the board how they stand by
Thursday of this week.
In the meantime the hos-
pital continues to receive its
regular budget from the
health ministry, although ex-
ecutive director Hayes earl-
• ier warned the beard this will
probably not be sufficient to
see' it through the year.
Nearly $170,000 was deduct-
ed from the budget this year
in an attempt to force closure
of 14 active treatment beds.
• According to Milosevic,
the board .has not yetitAtade
the deeision to proceed with
legal action and -in the mean-
time is looking for a show of
• public support in its Opposi.
tion to the bed closures..
•
•
• attk
bed issue
• The Wingham and District
• Hospital is prepared to fight.
Last week the hospital
board announced it had
decided to take the Ministty'.
_
of Health to court to contest
an order to reduce the nuM-
ber of beds..
• H•spital board chairman,
Bora \Milosevic issued the
statement last week. The
action follows the January
order of the Ministry to the
Wingham and District Hos-
pital Board to close 14 beds.
The board has retained the
Toronto law firm "of Lang,
Michener, Cranston and Far-
quharson to act on its behalf
in the action against the
Ministry.
The Ministry tried to force
• the.board to comply with the
closure • issue by deleting
$168;000 from the operating
budget. Last *month the
board claimed the govern-
ment refused to pay bills in
• the amount of $205,000 for
patient care during April and
May. The board said it.would
not send the government any
further bills.
There was no indication as
to what course of legal action
the board would initiate
against the ministry.
• Wingham and • District
Hospital board of governors.
decided Wednesday night
• tJiey will not proceed with
legal actichi against the Min-
• istry of Health in their ••
dispute to keep hospital bests
open. •V.
The board's management
Committee Met before the
Meeting and made a recom-
mendation •to .the board that
the legal action be dropped
in view of the obvious lack of
support from' the municip-
alities using the hospital. Dr:
Wilkins and Raye Elrnslie
opposed the motion. •
John Maim of the Citizens
Action Committee, reported
to the board their efforts to
raise money for legal costs
Wad failed. Only East :Wawa -
nosh supported the appeal.
,Dr, -Douglas Mowbray sta-
ted the managernent commit-
tee and the board really had
• no alternative due to the total
lack of support from sur-
• roundfq Municipalities.
"They've cast the dye and
will have to live with the
results," he commented.
On • a recommendation
from the hospital's medial
staff, the hospital will invite
a joint committee of the
Ontario Hospital Asktecjation
and the College of PINcians
to examine bed utilization at
the hospital. The ministry
has told the board there will
be no negotiation of the hos-
pital's funding until such a
study ,is done.
The board's Motion stipu-
lated that the ministry be
requested to provide *len
terms of reference and their
recommendations, stating
the study is their wish.
• The board fears the study
will becompleted and then
the ministry will change their
terms of reference making
the study an exercise in
futility.
The board made it clear '
the study is being done to
• Continue negotiations with
• the ministry over bed clesur-
es and budget cuts. The
hospital board is not conduct-
ing the study to determine a
lapse in medical standards at
• the hospital. •
osptia receives
additional funding
Wingham and • District
• Hospital has received
$45;000 from the Ministry of
• Health to be applied towards
its operating budget for this
year. When the budget was
• submitted to the ministry;
the hospital was $56,000 over
the ministry's net liability
and would have operated at a
deficit, if more funds were
not obtained from the minis-
try.
" The Ministry of Health has
had to review hospital bud;
gets in the province because
many were submitting bud-
• gets with operating deficits.
Ministry cost cutting pro-
granis were reducing funds
for operating budgets to the
point where hospitals were
submitting deficit budgets.
The ministry will grint an
additonal '1.5 per cent -of the
original allotment to hospit-
als with deficit budgets, if
the hospitals adhere to there
criteria. • •
Winghan met the follow-
ing criteria to qualify for the
additional 1:5 per cent.. The
hospital plosed. 14 beds to
meet the ministry's'becl level
guidelines and undertook a -
cost containment study with .
• the Ontario Hospital Assoc-
iation (OHA). Despite the
study, the hospital was un-
able to brinriin a budget
• under their original net lia-
bility and.therefore, qualified
for the additional funds.
The hospital is still nego-
tiating for the balance of
their operating deficit which
amounts to $10,500.
The cost containment
study by OHA to determine
cost saving had identified
$2,000 the hospital can save.
Another study, retommend-
ed by the hospital medical
staff in October, to study
utilization of services, v/111
get underway this Week.