Nurses are concerned with government plan for "patient focused funding"
The plan opens the door to more uncertainty and dislocation, when nurses are already stretched to the limit and health authorities are cutting services and staff to balance their budgets
Nurses have serious concerns with the so-called "patient focused funding" plan unveiled today by the provincial government.
The plan would replace already inadequate hospital funding that's forcing health authorities to close operating rooms, reduce beds and cut nurses, with a dubious scheme to pay hospitals based on the number of patients served and how quickly they can be sent home.
"We're alarmed that the government would push ahead with this concept when it leaves patients and care-givers open to so much uncertainty and problems providing safe care," says Debra McPherson, president of the BC Nurses' Union. "For example, the plan offers extra money to financially-pressed health authorities who shift away from letting patients recover from surgeries in hospital. Instead, they'll be rewarded for increasing the number of same day surgeries, in which patients are sent home hours after their procedure.
"While same day surgery may be appropriate for many procedures, there is no reason to think hospitals will only do them if they're paid extra. My fear is that with health authorities offered extra funds for same day surgeries, where will the funds come for the complex surgeries that require in-patient stays? Will the facilities doing those procedures be penalized?" McPherson asks. She says with more and more patients discharged after same day surgery, health authorities will require many more home care nurses to see patients in the community, but health authorities are cutting back community nursing now.
While the plan also would pay incentives to hospitals to get patients out of emergency rooms, all too often there aren't enough beds and staff up on the medical wards to care for them. In that case, hospitals would get extra cash, but nurses would be forced to care for patients in hallways and closets once they've left the ER.
McPherson is also concerned that the introduction of the plan — which is to be administered by a new bureaucracy called the "BC Health Services Purchasing Organization" — is a prelude to handing off more public dollars to private for-profit clinics, instead of investing funds on improvements in public healthcare facilities.
That's precisely what occurred when patient focused funding was introduced in the United Kingdom. Billions of pounds were diverted to foreign-owned private healthcare corporations while public hospitals scrambled to raise enough money to treat patients and pay staff. Former UK Health Minister Frank Dobson described what happened in a presentation in Vancouver in 2007. For more information go to http://www.workingtv.com/health-care-innovations.html.
"It's no accident here in BC this concept of ‘money following the patient' has been the hobby horse of Brian Day, owner of the for-profit Cambie Surgery Centre, which has refused to allow the Health Ministry to conduct a court-ordered audit of his clinic to document how many patients have been charged facility fees for surgeries that are covered by public health insurance."
McPherson is also concerned that several of positive healthcare successes the government is citing to justify proceeding with the plan had little or nothing to do with patient focused funding at all. Instead, dramatic reductions in patient waiting times for hip and knee surgery and better patient flow in emergency rooms were the result of process improvements that brought more efficiencies and effectiveness to hospitals.
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