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The Goderich Signal-Star, 1974-10-31, Page 23MOH. summarizes Mustard Report for county. council, the people BY D.R. FRANK MILLS ' 1. A District Health Services Advisory Committee HURON COUNTY MEDICAL, 2. A. District Primary Care OFFIpER OF HEALTH Committee „and a District. The Mustard Report is a Primary Care Advisory Com - report of the health Planning mittee Task Force, a group headed by '3` A District Secondary Care Dr. J.F. Mustard. This group Committee and a District Secondary Care Advisory Com - ,was appointe, in late 1972 to. do a compre nsive stud of mittee the health care elivery system 4• A District Committee on in Ontario particularly in Diagnostic Services regard to the re -organization 5• An Area Health Services plan of the Ministry of Health Advisory Committee that had been preseriited early 6. A Planning Committee in 1970. . 7. A Facilities Committee The Mustard Report is 8. An Education Committee totally destructive of the health 9. A Community Relations care delivery system as it Committee t. - presently exists in Ontario. It is One must bear in mind that modeled on the National all of these committees the District Health Council are Health Service of Great DANGERS Britain, and it is far more purely voluntary, (without pay) Now in speaking to many must meet regularly .and•t often restrictive to patient and involve the, member$ of the - physician recently and trying to physician than the National give them some idea, some un- ' Health Service of "'Great health manpower teams. A derstanding of the Mustat' l Britain. this is almost impossible, not The Mustard Report hinges can so -to -speak, "pin dawn" in on the establishment of three only because of the difficulty of their own mind, I have come distinct segments of health finding people to serve volun- up with a number of dangers in care: tarily on these committees, but the Mustard Report that will 1. Community Health Centres also because of 'the number of - be actualities if the Mustard meetings that must be held' by 2. District Health CouncilsReport is implemented. •The. 3. Area Health Services these committees secondary to dangers can<�be divided into: the District Health Council. Management, Board 1. Consumer Dangers It has been computed that in 2. Hospital Dangers First is the Community Ontario the •committee struc- ,3• :Professional Dangers Health Centre which is a ture as stated would required 4. Political Dangers facility, built on a population 4,800 voluntary workers plus.CONSUMER DANGERS basis of wte for every 15,000 an additional 200' , paid The consumer overall will have people. i.e., in Huron County positions of secret nd ad- a low -quality health care with_ a..._population-of:-52,000, ,,ministrative to_operate these there would be three Com- committee structures. This is system. The irrrtwould of the munity Health Centres. located not in keeping with any at_ Mustard Report indicate in geographically central tempt to reduce hea4th care there will be fewer doctors -for positions. All medical care will-., costs which was the original in- the areas, there will be fewer be given through ` the Com-' tent of the re-organizationplan. hospitals, for the areas, there munity Health Centres. " We must also deal with will be distance to travel to Community Health Centres anther very' important part of medical care .and the type of will house . all the health the District Health Council and health care that you- receive professionals. in the area, that that is: it is directed to form an will be determined by an inter - is, physicians; • nurses,`'socra•1 Area- Health Services workers, family counsellors,. Management Board which will public health nurses, dentists, be discussed in ,the next item. etc. At a Community Health a MANAGEMENT BOARD ' Centre, a sick person will first The third segment then' in - have to deal with an inter- volved in the Mustard. Report mediary person who will decide is the Area Health Services whether they need to see a doc- Management Board. This is a tor, a nurse, or any ..of the very .powerful body which will people listed above.. (This operate either one or a number barrier to physician -patient of institutions depending on the relation has never been • found size and the population,' The in Canada before and is unac- Area Health" Serovices ceptable to the general public ''Mariagernent Board will most of .whom feel that once. replace all existing, hospital they have made up their mind boards and may have represen- to visit a-phy:,iciuii; therwa •lth a ion rom the existing be annoyed to be channeled to hospital boards but does not another -health professional have W. It again is appointed without choice.) through the Minister's office. Community Health Centres The Area 'Health Services must be built by local funding Management Board not only DANGSPI according to information from will Operate the hospitals in the TO THE HOSPITALS the Ministry of Health over the area, but will also decide on I must again state that there is past two years. The formation the - number of physicians every indication that there will of Community Health Centres present in the area and sur- be indeed fewer hospitals, that involves the development of a veillance on, the quota system hospitals must be of a 300 bed public transportation system for physicians within the area. size, that there will be one, ap- for the Health Centre which This is something that we must pointed • board for•'"several again must be developed and think;of also, that there -will be hospitals, that is the Area funded locally, but as indicated a quota system for physicians Health Services Management in the . Mustard Report, free for our area as with all areas; Board, that there will be only transportation. must be -that the number will be preset special services of a limited provided to the Community on a. population basis as yet to type in the ed to r main spital Health Centres. be determined; that we may that is allowed to remain, and DISTRICT HEALTH COUNCIL face a reduction &of. physicians' that most of the more - community hospitals to develop them and make them a great , service to our community. It has even been noted that over the years many of the com- munity l}ospitals.have been en- dowed from former voluntary hospital board members. In- deed, some of the larger city hospitals have had generous endowments from former board members. Again, this voluntary effort has not only built our hospitals and made them what they are today but in some cases, it even led to financial support through endowment .af- ter death. This appears to be totally forgotten, and this will certainly pass, if the Mustard - Report is implemented. committee structure such as Report, something that they th' 1 mediary person of non- orofessional standing. Consumer dangers also must include the tremendous in- crease in costs; the .obvious costs being the'cost of building Community Health Centres, the cost of developing a free transportation system to the Community Health Centres, the cost of operating the tremendous committee struc- ture with 4,800 volunteers and 200 additional civil service positions. There is no doubt that the taxpayer will s-uffer, that there will indeed be a ° t e.mendous increase in the cost of the new health care delivery system as presented in' the Mustard Report. decides to come into the area when there is no vacancy on the quota system. I am personally concerned too,' as a 'physician, with the dissolution of the -doctor- patient relation, that a `barrier will be ° erected ' to patient - doctor relation and that it will become most unacceptable with first of all the patient being filtered out by an intermediary to say whether he may lir may not see the doctor and the doc- tor also being filtered out from the patient by an intermediary iary who determines whether the doctor should or should notsee the patient. . • W'e must remember also that in the Community Health Cen- tre set-up, that the Health Cen* tre must be staffed twenty-four hours a day with all., health professionals and ' that, therefore, doctc3'rs will be on shift work and that the possibility .of the consumer seeing his favorite physician at the time that he is ill is remote on sheer °m.athematical probability of the patient being ill when the 'doctor is on duty or on 'his particular shift at the Health' Centre. ' Another professional danger is the demoralizing effect that this total report ,has" had on hospital. staff arid on all health professionals by making them feel that they are no `longer needed. as personally interested professionals- looking' after a patient's welfare, but ' rather only as push-button pawns .T,to do a specific technical job and show no interest or personal concern for ..the health ° con- sumer. POLITICAL DANGERS, The loss of local control of ,our health services to 'a' more distant body as implied in the District Health Council for the area encompassing the file counties and involving the tremendous centre of population and specialized health care in the university area of London. • A political• person most be concerned and is concerned that there would be •in prac- ticality no way that we would have a voice on the .Health Council when we are only 50,000 people in a total population of ryii-51");OTT0-." Ve r would he overwhelmed and' soon forgotten. WHAT TO DO Many have said to me, "`What can 'we do," when they have read the. report and ' I. think everyone should avail themselves with a copy of the report and read it, (although it is heavy reading and tends to., give you a strong feeling of . sleepiness) bear with it, and as you 'read through it you will find the points I have outlined above to he as stated. If you ••conclude, as I have concluded, that this proposed health care delivery system isa disaster -to health care, in On- tario and as many have won- dered what. can 'a person do, I certainly would urge you to sit down and write a .letter of rejection to the Minister ° of Health,, to your local M.P.P,s and to the •preinier of Ontario. • Letters of objection, letters of ;rejection and -letters of concern must be sent as soon as possible •if there is to be any hope of stripping the implementation of this, report as presented I have noted that. when the occasional persbn has objected, he has received a watered • - down reassurance 're. the Mustard Report, such as, "Well w • e wouldn't use all of it, we will just use parts of it", but I would like to point nut that Dr. Mustard °himself has stated that there can be no small part of the Mustard Report omitted.. It hinges together. It must be all or nothing and• certainly with what we have in Ontario today in Lour health care delivery system, it is my feeling that we do not need the Mustard Report. We do .-not need to add un- necessary costs to health care and if one really is interested in developing efficiency in the' health care system, then ,,,they should start at the community level' and find out .from the people who are the consumers of health care and the physicians and' nurses who are the ' people giving the health care what can be done. To im- pose a' major re -organization plan without prat• ical ex- perience and knowledge of health are as it actually is at the consumer level is an im- possibility and the Mustard Report certainly demonstrates this in its conclusion and recornmendatinn�' The second main segment is . on a population base, because specialized services will have to the formation of the ,District although we are large in area; be obtained in the catchi,►ent Health Council. (In 1972 the ,• we are small in population area of the large London health original re -organization plan of numbers. area. For any detailed special - the Ministry , of ,Health ,in -A physician may• not come service, I think it is implied dicated that a. District Health into an area to practice unless and can be concluded, that we •,'. Council would be required and there is a vacancy in the quota , will indeed be required to go to that it would be composed of system for the area.:tif he our catchment area, that is to representatives frorp•-the- health decides to come into the area , the London University Centre. profession; a physician, a nurse; and practice regardless of, the In ' the hospitals also, the -a hospital representative, a ' openings, he will ,not be suppor- dental representative, each oneted by O.H.I.P., and , this is of the, 'health'\professions, and stated clearly in the Mustard an equal number of Interested Report. "No O.H.I.P. payments consumers. fo-r a physician who practices ''These together would make outside of the quota system and up a District Health Council where there is no vacancy with --.the intent of co-ordinating available in the area." and integrating health services Another important im- within the area' they .serve.) plication of the °Area Health However, the Mustard' Report Services Management Board is ha's revamped the Health in. regard to our hospitals. The Council, has removed any Minister of Health, at a health professional member- meeting of the Ontario Hospital ship On it, and simply states Association in Sault Ste. Marie that the District Health Coun- in September of 1974, stated 'should not have been cil would be appointed • by that the optimum size for a overlooked aid cannot be e* - statute composed of ten mem- hospital to .operate efficiently petted to he continued when it bers, who must have no was 300 beds, and that we becomes strictly a governmen- relation to the health should aim for this figure. This, tal hospital. , professions and no health of course, has great importance At • a ,recent meeting of professional background. • to Huron County where we District No. 2 of the Hospital ,.The District Health, Council have five municipal hospitals. Auxiliaries 'of Ontario, it was which has been suggested for with a total of a little over 400 pointed out that" in the past Huron County would include beds and concluding from the year $148,000.00 had been Huron,,,,Perth, ' Oxford, Elgin, «Ministers remarks, we would raised by the member Middlesex and London with a have to *say that in Huron auxiliaries to buy equipment total 'population of 550,000, County, wet would be,c,left with and furnishings for the and as, can easily be seen the one 300 bed hospital at the hospitals in the areas they possibility of a voice from ` most. ,From this, we :see that serve. This is only one year of Huron being heard in such'::a` the five municipal,hospitals aremany ,that they have been in large fio,pulation area is'�R' going to have to reduce in num- existence incl operation and remoile.bar, and the implication is that fund raising. • The District Health'Council .sorne_of these hospitals will in- PROFESSIONAL DANGERS is a very important part of the -deed be closed. As a professional myself, I plan. It is, advisory' to the Another sad thing about the must speak for my colleagues Minister and the Ministry. It hospitals is the` dissdlutigrt of and say that it is obvious that must meet with alt voluntary the hospital boards. Over the there will he a set number of agencies and„ work with all years, hospital board members doctors and health social and community service have been a dedicated and in- Professionals for any area; and agencies. It is required to form tei•eated group, have given that there would be no O.H'.I.P. the following committees: many hours of service to the payment for a doctorwho • m danger is the lack of the Volun- tary. organizations, There was strong objection registered from the Wofnen's' Auxiliary of the Goderich Hoa.pital at 'the time of the County Council discussion of the Mustard Report indicating that the Women's Auxiliary over the years had gone out of their way, put much effort into raising funds to buy necessary equipment forthe hospital and to furnish the hospital and that " this - type of voluntary work w7 GQPBRICJ SIGNAL -STAR, THURSDAY, OCTOBER, 31, 1974 -PA 'E M Now Available On 1ST AND 2ND MORTGAGES Anywhere in Ontario ° On RESIDENTIAL, COMMERCIAL, INDUSTRIAL and FARM PROPERTIES Interim Financing For New Construction & Land. Development For Representatives In Your Area Phone 4,ID SAFE'WAY INVESTMENTS CONSULTANTS LIMITED (519) 744-6535 Collect Head Office - 56 Weber St. E. 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