Thursday, May 20, 2010

Less Med School positions

Provincial cuts mean fewer med students accepted at U of A
By Elise Stolte, Edmonton Journal May 14, 2010 •Story•Photos ( 1 )
"It's our job to make sure University of Alberta education remains second to none," says Philip Baker, dean of medicine and dentistry. The U of A's medical school is accepting 167 new students - down 21 spots - as a result of funding cuts in the provincial budget.Photograph by: Supplied, edmontonjournal.comThe University of Alberta's medical school will send acceptance letters to only 167 new students today as a result of funding cuts in the provincial budget, say university officials.

That's 21 fewer students than were accepted last September, but better than the worst-case scenarios being floated in April.

The University of Calgary is accepting 170 new students, down from 180 last September.

The province increased funding by "a little bit" since the February budget came down, said Fraser Brenneis, vice-dean of the faculty of medicine and dentistry.

The two groups had long negotiations to mutually approve a final number of new students. Schools are still waiting for their grant letters with the final budget numbers.

Cutting spaces for first-year students won't save much this year, since the highest costs hit in Year 3, but "you have to be able to cover that student for the full four years," said faculty dean Philip Baker. "It's our job to make sure University of Alberta education remains second to none."

The province is giving the school $72,366 per medical student per year. Overall, the university took a five-per-cent cut, which meant a $2.8-million cut for the faculty of medicine and dentistry.

Baker warned students to expect fewer incoming students and cuts to educational supports in an e-mail last April, while also asking them to support tuition increases.

Jasmine Pawa, head of the local medical students' association, said the final number of letters going out today "is probably a happy medium, considering financial circumstances."

But it won't be the end of their fight to get more funding for doctor training, she said.

Others criticized the move as being short-sighted.

"Clearly the minister's targets are far too low," said David Eggen, director of the Friends of Medicare, adding that many Albertans don't have family doctors. "We have a serious shortage of physicians in this province."

Liberal Leader David Swann called it a "backward" step. "We know the number (of doctors) we need, let's get on and do it," he said.

Trevor Theman, registrar for the Alberta College of Physicians and Surgeons, called the current cuts "not huge numbers," especially when considering the increases in student spaces over previous years.

Canada doesn't produce enough doctors to meet demand," he said. Currently, 32 per cent of Alberta doctors were trained in other countries, and that number is increasing.

estolte@thejournal.canwest.com

Fast Forward!

Private health-care hospital on life support
Province plans to take over surgeries next year

Published May 20, 2010 by Trevor Scott Howell in News



It's ironic taxpayers have to bailout a private hospital, says David Eggen, executive director with Friends of Medicare


As Calgary’s population grew in leaps and bounds in the mid-1990s, the province shut down three inner-city hospitals. And shortly after blowing up the 960-bed General Hospital, the province sanctioned a private-care facility — one that was supposed to reduce surgical wait times and save taxpayers some money.
But that very same facility that, ironically, took over a shut-down hospital, is now in a bankruptcy dispute and is being bailed out by the province — temporarily, until the health-care system gets its massive overhaul — leaving taxpayers to pay millions toward bank loans, a creditor receiver and to continue performing surgeries until next February.
“The whole thing is absurd,” says David Eggen, executive director of Friends of Medicare. “Health Resource Centre was given a golden ticket to provide private delivery of public surgeries. How can you go broke on a sweet deal like that?”
That “golden ticket” was the tens of millions of dollars Alberta Health Services gave to the Networc Health Inc., which owns Health Resource Centre (HRC), for doing about 100 orthopedic surgeries per month. And after performing mostly hip, knee and ankle surgeries, the 37-bed HRC planned to expand into a larger, new health complex that started construction in 2008.
According to court documents, HRC claims the province promised the private health-care centre it would triple the number of annual patients —to 2,733 — who would otherwise get care in the public system. But HRC says the province pulled the carpet out from under them last July by reneging on the deal.
Even though HRC was told by the province it likely wouldn’t get as many surgeries, construction of the new facility continued. In a letter last December to confirm discussions and agreements, the construction company wrote to Networc Health Inc: “We understand that there have been delays in finalizing your agreement with Alberta Health Services as a result of internal reorganizations within the Alberta government, but that you expect it will be completed in January 2010,” wrote Brad Regier of Clark Builders.
The “internal reorganization within the Alberta government” is a mammoth restructuring of Alberta Health Services. In March 2009, Alberta Health Services hired Stephen Duckett from Australia to repair the province’s ailing health-care department and its $1-billion deficit. As well, in just two years the health department had three ministers — heads who had their own strong ideas of how to run the department, such as Ron Liepert, who dismantled Alberta’s nine health regions and created a “superboard.”
There was plenty of belt-tightening to do, says Richard Plain, a health economist. “The economic crunch forced the government to tighten the budgetary screws, required Alberta Health Services to borrow $750 million to meet payrolls, and enacted a hiring freeze.”
As for the number of future surgeries contracted between HRC and the province, the executive vice-president and chief financial officer for Alberta Health Services says Networc committed to expanding without having a deal in place with the province. Negotiations were ongoing when the matter hit the courts in April.
“No deal was ever finalized,” says Chris Mazurkewich, adding the two parties had talked about a maximum of 2,700 cases, but some types of medical procedures, including spinal surgeries, weren’t yet approved by the province.
“It wasn’t the services that they had been delivering up to that point. We were looking to expand the type of surgeries they could do,” he says, adding the province simply couldn’t give HRC many more patients needing knee, hip and ankle surgeries. “We didn’t have enough of the normal volume that they were doing.”
As well, the province claims in court documents that it could legally terminate the surgical agreement it had with Networc “without notice, costs, penalty or process of law if Networc becomes insolvent, bankrupt, is placed in receivership or commits any act of insolvency.”
The Alberta government plans to do in-house surgeries — ones that HRC has been doing for years — after February 2011 at the new McCaig Tower, an expansion of the Foothills Medical Centre, which is now under construction and slated to open in January.
“We’re doing these actions in order to protect patient care and ensure people receive timely services,” Mazurkewich says. “Nobody’s happy with the situation we find ourselves in, but we’re trying to do what we see as in the best interest of the patient.”
The province’s decision to do these surgeries in-house likely doesn’t bode well for HRC’s business tycoons. (In the year 2000, there were 65 HRC investors and now there are currently a handful of board directors making the major financial decisions.)
When contacted by Fast Forward Weekly, board director and entrepreneur Frank King, who spirited Calgary’s 1988 Winter Olympics, says he couldn’t comment because there is a “gag order.” As well, Networc Health CEO Tom Saunders says he couldn’t talk about the matter because it is in the courts.
Wendy Armstrong, spokesperson for Consumers’ Association of Canada, says a problem with relying on private companies is that they “come and go” through bankruptcies, takeovers and mergers. “So you have no control over their business decisions about what kind of risks they may take, which may lead to the disappearance of that clinic at the end of the day.”
Since HRC’s beginnings, Armstrong has witnessed some major events unfold. When HRC applied for accreditation, there was much debate, and criticism that the private hospital — the first in Alberta — was contravening the Canada Health Act. Former premier Ralph Klein’s government favoured privatization and the hospital was hailed as being the future of medicare. After HRC was approved, other provinces, including B.C. and Ontario, opened private hospitals.
“One of the things a lot of people don’t appreciate, because physicians tend to be the front-face of many of these clinics, but my research through the years shows that much of the impetus for these clinics comes from businessmen looking for opportunities for high returns on their investments,” Armstrong says.
Some others don’t appreciate entrepreneurs trying to profit from essential health care.
“It was a group of investors who saw the government’s ideological bent on privatizing health care, so they manipulated an opportunity for themselves,” says Eggen. “The government deliberately reduced the number for beds available in Calgary to soften the ground for this kind of thing and gave the businessmen a sweet deal on a public hospital — the same place we are now renting back for $114,000 a month.”

Thursday, May 13, 2010

The money pit

Health board steps up surgeries to recoup costs of Health Resources Centre
By Colette Derworiz, with files from Tony Seskus, Calgary Herald, Calgary Herald; May 13, 2010 7:25 AM

Alberta's medical superboard filed an application in court to have an interim receiver appointed to a clinic that performs hundreds of publicly funded surgeries at the Health Resource Centre, formerly the Grace Hospital.Photograph by: Colleen De Neve, Calgary HeraldAlberta Health Services said Wednesday it's unlikely the medical superboard can recoup all of the money being paid out to prop up a privately run surgical centre until January.

The health board is spending at least $2 million to keep Health Resources Centre operating for the next eight months after it bought $1.3 million of the company's outstanding bank loans and will pay up to $690,000 in interim receivership costs.

The provincially funded authority will also pick up the facility's operating costs -- including $960,000 in rent for the next eight months -- until it can start performing the surgeries in the new Mc-Caig Tower at Foothills Medical Centre.

AHS chief financial officer Chris Mazurkewich said the organization is trying to increase the number of knee, hip and ankle surgeries performed at the private centre to recover some of the additional costs.

"The more volume we put through, the more that frees up cash flows to reduce those exposures," he said in an interview. "The best we would do is break even. That would be the best.

"We are at risk of having to put money in. Right now, I don't have a good number on that."

Although he suggested it could be possible to recoup the $1.3 million, Mazurkewich acknowledged there's a risk they'll have to absorb the receivership costs -- listed at $690,000 in court documents.

Dave Eggen of Friends of Medicare said he doesn't expect taxpayers to get their money back.

"Taxpayers are getting hosed on this," he said. "We're using public money here to support a private enterprise."

The first financial report from PricewaterhouseCoopers -- the receiver appointed by the court to run Health Resources Centre until January 2011 -- shows AHS has already lent $500,000 to fund initial operating cash requirements, including the May rent, at the centre operated out of the former Grace Hospital.

It also suggests the surgical clinic, owned by Networc Health Inc., would not have been able to carry on its operations "without a cash injection of approximately $7.2 million . . . or an arrangement with its creditors."

Financial difficulties at the centre surfaced in April when AHS took the unusual step of filing court action to fend off the possible bankruptcy and closure of the clinic that provides one-third of Calgary's hip and knee operations.

Networc is in a legal dispute with the Cambrian Group of Companies, which claims it is owed more than $65 million for a 10-year lease on a new surgical facility that Health Resources Centre had planned to move into this year.

Frank King, one of Networc's directors, said he believes Health Resource Centre will survive.

"There will be, in the future, everything that there is now -- and more," he told the Herald. "This is an unfortunate thing that has happened. We think that all parties important to it will find the right path."

cderworiz@theherald.canwest.com

© Copyright (c) The Calgary Herald

Wednesday, May 12, 2010

Winnipeg Free Press

Surgeries to continue at private Calgary hospital, but at a cost to taxpayers
By: Bill Graveland, The Canadian Press

11/05/2010 5:18 PM
Print E–mail Share ThisReport Error CALGARY - A private hospital teetering on the edge of bankruptcy will remain open to perform publicly funded surgeries in Alberta for the next 10 months.

But the province's health provider ended up paying $1.3 million to one of the hospital's creditors to bolster its legal case that the facility keep operating.

The Calgary-based Health Resource Centre has done about 1,000 hip, knee, foot and ankle surgeries a year — about a third of the total done in Alberta — for the last four years.

But an ongoing legal dispute between Networc Health Inc., which owns the centre, and creditor Cambrian Group of Companies had the hospital on the verge of shutting down.

Queen's Bench Justice Barbara Romaine prevented that on Tuesday by appointing PricewaterhouseCoopers Inc. as the interim receiver until Jan. 15. She also stayed any bankruptcy proceedings against the facility until that time.

The move came at the request of Alberta Health Services, which was worried about a glut of cancelled surgeries if the centre were shut down.

"This is wonderful news for the patients who were waiting for orthopedic services within the city of Calgary and surrounding area," said Chris Mazurkewich, chief financial officer for AHS.

"We're very excited by this. It means uninterrupted patient care until January, which is exactly what we asked the court to do."

Cambrian had been arguing that AHS was in no position to stall bankruptcy proceedings because it was a customer, not a creditor, so AHS bolstered its legal position by paying $1.3 million to the CIBC. The bank had claims against the centre's assets and cash flow. The move made AHS a secured creditor.

AHS will also be on the hook for $114,000 a month in rental fees to the owners of the facility.

After the 10-month period, surgeries will be done "in-house primarily at McCaig Tower and some of the other hospitals within Calgary," Mazurkewich added.

McCaig Tower is the new wing at Foothills Medical Centre. It will include operating suites, a new intensive care unit and medical laboratories.

The Health Resource Centre was originally the Salvation Army Grace Hospital, one of three Calgary hospitals closed in the mid-1990s.

One of the government's harshest critics on health care said it's an expensive lesson.

"Paying over $100,000 a month in rent for this building that we used to own really adds insult to injury for the public," said David Eggen with Friends of Medicare.

"It has cost millions of dollars to bail these guys out. Do the math — this has cost us at least $3.5 million — $4 million. The irony of this situation is pretty thick down there in Calgary. This experiment to do public services through a private contract is an expensive, disastrous error."

Tuesday's developments came despite a move by Cambrian to have its bankruptcy application against the centre withdrawn.

"The insolvency situation is addressed," Cambrian lawyer Michael Smith told court.

A review of the centre's financial situation by PricewaterhouseCoopers Inc. found that while the centre was not "flush with money," it wasn't as bad as originally thought.

But Mazurkewich said the analysis suggested the facility needed protection.

"HRC as it currently exists is insolvent and so in order to protect patient rights to make sure they get treated we had to make sure nobody else went after HRC and wanted to put them into bankruptcy."

"From our perspective we're prepared to pay the price to make sure people get uninterrupted services and that's what we've succeeded with at the courts today."

Private delivery experiment explodes!


Alberta Health Services to pay extra to keep Calgary private surgery clinic operating until January

By Colette Derworiz, Calgary Herald May 11, 2010 Be the first to post a comment
•Story•Photos ( 1 )
Alberta's medical superboard filed an application in court to have an interim receiver appointed to a clinic that performs hundreds of publicly funded surgeries at the Health Resource Centre, formerly the Grace Hospital.Photograph by: Colleen De Neve, Calgary HeraldCALGARY - Patients will continue to receive their publicly funded knee and hip replacement surgeries at a private medical facility in Calgary until January, but it will come at an additional cost to taxpayers.

Alberta Health Services filed an application in Court of Queen's earlier this month in a bid to ward off bankruptcy proceedings caused by a legal dispute between Networc Health — which owns the Health Resource Centre — and one of its creditors, Cambrian Group of Companies.

The surgical centre performs nearly 1,000 publicly funded hip, knee and ankle surgeries each year

AHS, which has become a secured creditor after paying off a $1.3 million bank charge against the cash flow of HRC, was initially granted a one-week interim receivership order by the courts last week.

It was extended by Justice Barbara Romaine this morning until Jan. 15, 2011.

"This is wonderful news for the patients that are waiting for orthopedic services in Calgary and surrounding area," said Chris Mazurkewich, chief financial officer for AHS. "It means uninterrupted patient care until January, which is exactly what we asked the court to do."

AHS had agreed to pay the interim receivership costs, which will cost about $600,000 until January.

The health superboard will also pick up the monthly rent — which is another $114,000 per month — paid by Networc Health to Northwest Health Care Properties, which is the landlord of the former Grace Hospital.

David Eggen, executive director of Friends of Medicare, said it's an expensive lesson.

"The ideology that says private contracts for public health services is deeply flawed, expensive and unhealthy," he said in an e-mail to the Herald. "AHS paying $100,000 a month on a building they sold for a song just rubs salt in the wounds of the paying public.

"The irony is thick in Calgary today," he added.

Mazurkewich, however, said it's a small price to pay to ensure people get uninterrupted services until they can move the surgeries back into their own facilities.

McCaig Tower, which is being built at Foothills Medical Centre, will open eight operating rooms later this year and will be able to add surgeries by January.


cderworiz@theherald.canwest.com

Tuesday, May 4, 2010

News Columnists / Andrew Hanon
Lobbyist steps down from Alberta Health committee
By EDMONTON SUN

New Democrats are claiming victory after a drug company lobbyist quit the government committee advising on a new Alberta Health Act.

But the chairman of the committee calls the New Democrats' outrage "puzzling."

Dr. Trish Bayne quit the 16-member committee on Monday, four days after NDP Leader Brian Mason called for her ouster.

Mason argued that as a registered lobbyist for pharmaceutical giant Eli Lilly, Bayne shouldn't sit on a government committee that's going to advise on new laws that might affect the company.

"There's a clear conflict of interest," Mason said Monday.

'PUZZLING'

But Edmonton-Rutherford Tory MLA Fred Horne, who chairs the committee, says it's "puzzling" that Mason is complaining now, when he knew that Bayne was a member of a previous advisory committee under then health minister Ron Liepert.

He added that the Alberta College of Physicians and Surgeons is a registered lobby group, but no one has objected to doctors being on the committee.

In fact, he argued, it's the members' involvement in the health-care system that makes them so valuable for the committee.

"These people have high levels of expertise in their own right," Horne said. "It was their report that initially was the basis for this current round (of committee work).

He added: "They're not writing the legislation. They're a group of stakeholders who have been involved with the earlier report and they're helping to facilitate discussions with other stakeholders."

Horne said Bayne didn't resign because she thought she was doing anything wrong. Rather, he said, she worried that the controversy would detract from the committee's work.

In an e-mail to the Edmonton Sun Monday night, Bayne said, "once you become an issue, it makes it difficult to continue to contribute fully. I therefore believe that the best thing I can do to support this important work is to step aside.

"It was an honour to participate with a dedicated and well-rounded group of individuals, all of whom put their personal and professional interests aside to engage in consultation and vigorous debate toward legislation to shape a health-care system of which all Albertans can be proud."

Mason said the government deliberately tried to hide the fact that Bayne was a lobbyist.

Her biography on Alberta Health's website does not directly mention that she works for Eli Lilly. Instead, it says she has "almost 10 years of experience in policy and reimbursement for the pharmaceutical industry."

David Eggen of Friends of Medicare called it "an awkward appointment, for sure. Perception is everything."

Eggen, who plans to run for the NDP in the next election, said the fact that Bayne is off the committee so quickly "shows that the government knows that the public is carefully watching this Alberta Health Act unfold."

CANADA HEALTH ACT

In February, newly minted Health Minister Gene Zwozdesky -- who replaced Liepert -- announced his plan to establish the act, which will complement the Canada Health Act, the blueprint for medicare.

It came after months of acrimony over Liepert's leadership style and poor communication.

Liepert sacked nine regional health boards and replaced them with an all-powerful superboard, mulled closing beds at Alberta Hospital and faced a human rights complaint over delisting sex- change surgery.

Critics panned Zwozdesky's scheme, saying it's just a smokescreen to hide the government's plans for delisting services and closing hospital beds.

But when he was named chairman of the advisory committee working on the new act, Horne said it will lead to "the re-establishment and renewal of trust between Albertans and government."

ANDREW.HANON@SUNMEDIA.CA

Monday, May 3, 2010

Health superboard scraps with creditor to keep private clinic operating
By COLETTE DERWORIZ, Calgary Herald May 3, 2010 12:50 PM
Alberta's medical superboard filed an application in court to have an interim receiver appointed to a clinic that performs hundreds of publicly funded surgeries at the Health Resource Centre, formerly the Grace Hospital.Photograph by: Colleen De Neve, Calgary HeraldCALGARY - A creditor of Networc Health asked a Court of Queen’s Bench justice this morning to dismiss an application by Alberta Health Services to ward off bankruptcy proceedings just because the government “dropped the ball.”

The medical superboard filed an application in court Friday to have an interim receiver appointed to a clinic that performs hundreds of publicly funded surgeries.

Networc Health, which owns Health Resource Centre, is in a legal dispute with one of its creditors, Cambrian Group of Companies — which is owed $65 million.

“The Alberta government is asking the courts to help them out when they dropped the ball on making sure that the private hospitals have an opportunity to compete with each other to deliver services at a reasonable price to the taxpayer,” said Cambrian’s lawyer Michael Smith. “If you are not going to do that, if you are not going to put it out to tender, then you get these kinds of problems.

“People get bids on their terms, they make their deal and then they go bankrupt.”

Smith said he doesn’t know of any other case in Canada where the customer can ask for an interim receiver to be appointed in a bankruptcy proceeding so the supplier can continue to supply the services at a loss.

“That’s unprecedented,” he said.

AHS, listed as a contingent creditor in the case, is asking for an interim receiver — PricewaterhouseCoopers — to be put in place to ensure that operations continue at the health centre.

“Our whole focus is on patients and patient care,” said Colleen Turner, vice-president of communications with Alberta Health Services. “The concern is just that we don’t want surgeries to be interrupted at that facility right now. It does take on about 1,000 of our orthopedic surgeries each year and that’s a substantial number. We don’t want patients to be disadvantaged by any kind of bankruptcy proceedings or any other applications.”

Superboard staff are also putting together a contingency plan to make room for hundreds of surgeries in public facilities if the private centre does, in fact, close.

The matter will be back in court at 1 p.m. when the judge is expected to bring down her decision.


With files from Jamie Komarnicki, Calgary Herald

cderworiz@theherald.canwest.com

© Copyright (c) The Calgary Herald