What does health system tranformation mean for Scarborough?

By Dr. John Wright,
President and CEO, The Scarborough Hospital

If there is one constant in healthcare, it is change. I’ve been involved in healthcare for many years, both as a physician and as a hospital administrator, and I can tell you that the changes we can expect over the coming years are unlike anything that has happened since the introduction of universal healthcare more than a half century ago.

The reason is simple. We cannot continue to spend upwards of forty cents of every tax dollar on healthcare—especially when inflation pushes that figure upwards each year.

In addition, the Ontario government has made it clear that our system must move from a provider-centred model to one that is more patient-centred—in other words, a system where the funding will follow the patient.

The government’s Action Plan for Health Care gives us a good sense of the type of changes hospitals can expect, and already the introduction of health system funding reform has begun to transform the way hospitals are paid for providing care to patients. The impact of funding reform and health system transformation will be profound, and it will present hospitals—including TSH—with some challenging decisions.

What does the future look like? Here a few things we can expect:

• Hospitals will begin to specialize and focus on what they do best; not all hospitals will do all things
• Hospitals will stop doing some things because of cost and/or quality
• Some services, such as non-complex surgical procedures or services such as diabetes education, may be moved into community settings
• Consolidations or integrations may become necessary, and more common, across the province as hospitals look to find cost efficiencies

While we have successfully balanced our operating budget for the past four years, we require an additional $17 million in 2012-14 to once again balance the budget, address cash flow issues and continue to invest adequately in equipment, systems, buildings and priority areas.

Still, I believe we are in a good position. We are moving ahead with implementing our Clinical Action Plan, with a focus on Chronic Disease Management—a direction that is well aligned with the province’s Action Plan for Health Care. We are expanding the role of our nurses, occupational therapists and pharmacists so they will work to the full scope of their practice. And we are committed to becoming a regional centre for vascular surgery.

Already our satellite dialysis units have provided a successful model for moving hospital services into the community, and we are proud to be a leader in providing care to our hemodialysis patients closer to home. This is one of the finest examples of providing the right care, at the right time, in the right place that I have ever seen.

Being a two-site hospital also provides us with opportunities to integrate services within our own organization, without having to refer patients elsewhere.

Our healthcare system is under a great deal of pressure to change, and we know tough decisions will need to be made in order to make services more responsive to the patients we serve. Over the coming months, I will be meeting with patients, community groups, elected officials and community members to explain some of the changes ahead.

I firmly believe our community needs to understand the issues, and to be part of any decision making that impacts healthcare delivery here in Scarborough. I will continue to share information with you as it becomes available, and I welcome any questions or suggestions you may have.