"Question period is theatre." Apparently, so is governing the province.
Premier Kathleen Wynne's approval rating sits at a dismal 16 per cent. Her party has been dogged by scandals and misdemeanours over their 13-year tenure.
Even her choice to prorogue Legislature, wiping the slate clean with last week's Throne Speech, failed to impress voters. With a promise of an eight per cent Hydro rebate so that more families can afford heating and eating, I wonder: how much of this is sleight of hand to placate voters in time for the 2018 elections?
The reason I care what my provincial government does is simple: health care in Ontario is in a downward spiral -- I see it everywhere, even in my small town family medicine practice. At this point, the government must step up and stabilize the situation.
I've been in independent practice for seven years. In that short time, I have watched resources dwindle. The daily struggle to find help for patients is demoralizing.
Waitlists are now the norm. I no longer remember a time when they didn't exist. A year for a plastic surgery consult. Three months for an elective MRI. One year for an ophthalmologist. Four years for a spine surgeon. Six weeks for a crisis mental health appointment. Twenty-eight days for a cancer diagnosis. The list goes on -- as do the waitlists.
Our health-care system is under-funded and mismanaged.
It's as if my patients are stuck in suspended animation waiting to return to health. Except as they wait, their health deteriorates. They go on short-term disability. Family members can't work because they must be caregivers. Finances grow tight. Patients become depressed. Caregivers become depressed. I struggle to find them more answers, more care. The personal cost of waitlists from a patient perspective is astronomical. I see it and feel powerless to help.
The worst part: waitlists for medical care are not normal.
Waitlists exist because available health care resources do not match actual real-world patient need. When you don't have enough care, you ration and prioritize. The doctors, the nurses, the beds, all go to the sickest; everyone else waits. The problem is at this point, there isn't even enough for the sickest -- a case in point: the stem cell transplant debacle.
Our health-care system is under-funded and mismanaged. Years of shortchanging the care patients actually need, imposing unrealistic budgets on the system while diverting money into unnecessary bureaucracy manufactured this crisis.
Research shows each decade sees less and less of the health-care budget invested in the building blocks of care: doctors, nurses, hospital beds, equipment and ORs. More and more is spent on administration: committees, managers and consultants who spit out reams of redundant reports. Compared to other countries: we have an extraordinary number of bureaucrats managing the health-care system; we spend an extraordinary amount of money on health care; and our patients waste an extraordinary amount of time on waitlists.
Data shows patient outcomes worsen as money is rerouted from the fundamentals of health care -- doctors, nurses, hospital beds. More doctors means fewer premature deaths. So investing in front-line health care -- direct patient care -- matters. The fact that this year's CIHI data shows more doctors graduating is good. It's necessary: in the 1990s, government cutbacks drove one in 12 family physicians out of Ontario while scores of medical student training spots were cut. It takes nearly a decade to train a doctor. So it's taken us nearly three decades to make up for that irrational government policy.
However, having more physicians isn't helpful if these new graduates remain jobless -- unable to work in hospitals and unable to open community clinics -- in the face of overwhelming patient need.
Last year alone, escalating cuts to physician services totalled nearly $1 billion. Not surprisingly, community doctors struggled to keep medical clinics open. Much of the money I earn is invested back into my practice's infrastructure.
The medical profession exists to serve patients. To do this, we need clinics, secretaries, office managers, nurses and technicians; we need medical-grade equipment and computers, desks and chairs. We buy it and pay for its upkeep and eventual replacement. Physicians are now trapped in a business model where day-to-day operating costs rise while revenue falls. Some can and do work more to make up the difference. But there are only so many hours in the day and at some point, after a 60-, 70-, sometimes 100-hour work-week, even doctors tap out.
For many clinics, the only way to survive is to cut expenses -- cut hours of operation, staff and services. One recent example is on-site labwork. Many small-town family doctors fund such labs out-of-pocket to save their patients a two-hour round trip to the nearest government-subsidized lab. Such services are now endangered.
And when all else fails, doctors take down their shingles: dermatology clinics. Ophthalmology clinics. Barrie's outpatient gastroenterology clinic. Windsor's PET scanner. How can Health Minister Hoskins ignore the growing body of evidence of harm from his government's short-sighted policies?
The government's choice to cut funding for physician services is not based on reality or evidence. Their choice to cut funding to the health-care system is not based on reality or evidence. Sure, it may help the Ontario Liberals achieve their campaign promise of balancing the deficit -- but it certainly won't fix the debt.
And the price of that promise: my patients and I wait.
And wait.
And wait.
In the meantime, I speak up. I cannot remain silent because silence means being complicit to the government's bad decisions. You too have a choice here: rise up, speak up -- or accept the status quo as good enough.
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