If LHSC ends up doing less, who will pick up slack?: Expert

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With a direct hand now in running London’s largest health care centre and teaching hospital, the Ontario Health Ministry will face tough decisions on its future, such as whether to “find efficiencies” or cut services, a health policy expert says.

To find efficiencies, London Health Sciences Centre may continue to reduce staff and change how it does business, and if it offers fewer services, more patients may seek care at clinics or other hospitals, said Raisa Deber, professor in health policy at the University of Toronto.

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“It is feasible they may run more efficiently, they may alter how they use nurses, contract out work or just do business differently,” she said. 

“They may do less, but then who will do it instead?”

Offering fewer services at London Health Sciences Centre may result in family doctors and private clinics getting busier, in-home care demands increasing and patients  travelling to other hospitals for treatment, Deber said.

The Canada Health Act states the province must pay for care delivered by a doctor or in a hospital. If care is delivered by a nurse-practitioner in a clinic, OHIP may not cover the cost.

The province’s Bill 7 or More Care Better Beds Act states a hospital can place discharged patients into long-term care homes not of their choosing. There is a court challenge to that act.

“If you leave the hospital, the province may not pay for it. The province wants to get people out of the hospital so they don’t have to pay for care,” Deber said.

“The individual will pay.”

Queen’s Park appointed a supervisor on Wednesday to oversee London Health Sciences Centre’s operations and its “concerning financial performance” amid a mass resignation by its board of directors.

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LHSC terminated 59 managers and demoted 71 others with pay cuts earlier this month as part of its strategy to reduce a $150-million deficit in its 2024-25 fiscal year. 

Ontario’s health minister announced Wednesday that David Musyj, who was seconded from Windsor Regional Hospital to be interim chief executive at LHSC in May, has been appointed supervisor of LHSC. 

As supervisor, he reports directly to the Ontario health minister.

“A supervisor was named because either the people running it were messing up way too much, or they were trying to do too many things,” Deber said.

London West NDP MPP Peggy Sattler fears the move to a supervisor at LHSC may result in more hospital services being privatized.

“A hospital supervisor works for the government and this government sees privatization as an answer to health care challenges and that is not something Londoners support,” she said.

“It’s a possibility and I am concerned about it. We have seen this playbook before. 

“We think the solution is more family doctors and to pay nurses so we do not see constant turnover.”

In January the government announced plans to expand the number of private clinics offering services such as cataract surgery, MRIs and hip and knee replacement surgeries.

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Rob Flack, Progressive Conservative MPP for Elgin-Middlesex-London, could not be reached for comment Thursday.

But Sattler said she was “not surprised” the province installed a supervisor and the board stepped away although many of the province’s 140 hospitals will face a deficit.

“I know from front-line health-care workers the ranks of senior executives increased at a time there was underfunding, understaffing and an untenable workload on staff. Exorbitant salaries were being paid to executives and staff felt insulted. It was demoralizing.”

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