Hello Healthwatch enthusiasts!

Welcome back to your Weekly Dose of essential health news.

As ever, the healthcare scene is abuzz with critical updates. I'm here to guide you through the latest, making sure you're not just in the loop, but ahead of it.
Let's begin.

Ontario hospitals are in fiscal distress

Hospital stock

A report reveals that most Ontario hospitals are facing budget deficits and financial strain, with some reaching their limits, impacting patient care amid a healthcare crisis.

Why it's important: The situation has forced hospitals to take high-interest loans or use reserve funds, exacerbating challenges like crowded emergency departments and staff shortages. It might cause some to cut services this or next year, particularly in rural areas.

According to the Ontario Hospital Association, this is fairly unprecedented, and the implications aren’t good. The system, already grappling with overcrowded ERs and staffing shortages, is also faced with a grim financial picture. There’s a perfect storm of contributing factors here; the abrupt end of extra pandemic funding, rapid population growth, growing reliance on costly private agency nurses, and the overturn of Bill 124 which left hospitals on the hook for retroactive payments to affected staff.

Now, this goes beyond mere budget balancing. Essential health services are under threat. I won’t mince words, this demands immediate intervention to make sure hospitals can keep operating without succumbing to financial pressures — we don’t want more “Mindens” on our hands. I’m referring of course to a potential here for more permanent ER closures like the one that happened in Minden, Ontario last year.
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Canadian women are waiting longer than ever for gynecologic surgery

Canadian women endure prolonged wait times for gynecologic surgeries, spurring calls for urgent systemic change.

Why it's important: This points to a significant disparity in healthcare priorities and access, with women's quality-of-life surgeries being deprioritized over analogous procedures for men.

Pelvic organ prolapse (POP) is a medical condition where the uterus, bowel, bladder, or any combo of the above, descend from their usual positions, and bulge out of the vagina. Kate Revington's four-year wait for surgery to fix her POP is a testament to the disparity here. The delay isn’t just an inconvenience, it significantly impacts the emotional, physical, and mental well-being of patients.

The difference in wait times across provinces and the underrepresentation of specialized surgeons like urogynecologists exacerbate the situation. This has led to calls for a nationwide strategy to accredit urogynecology as a subspecialty and increase the number of qualified surgeons. Addressing these challenges isn’t just about reducing wait times; it's about equitable healthcare access for women and acknowledging the importance of their health needs. The current gender bias in healthcare reimbursement and prioritization needs a swift course-correct to improve overall health outcomes for women.
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Alberta ER doctors working without compensation amid systemic challenges

Alberta emergency doctors sometimes work for free, medical association says

In Alberta, emergency doctors are working long hours under immense pressure, sometimes without compensation due to delayed "good faith" payments.

Why it's important: Alberta's ER doctors are in a precarious position where they are forced to cover shifts and see patients without being paid, leading to burnout and a desire to quit.

"Good faith" payments, meant to compensate ER doctors for treating patients lacking ID or health insurance, were delayed due to a government decision to suspend them during contract renegotiations with the Alberta Medical Association. The payments were supposed to resume shortly after the negotiations wrapped up in September of 2022, but never did, resulting in doctors working without proper compensation.

There's a need for a mindset-shift here that treats frontline workers as investments in a healthy and functioning system, rather than administrative costs. The current situation in Alberta's ERs is a pretty glaring example of how administrative inefficiencies and neglect can lead to a cascade of problems affecting both healthcare providers and patients.
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B.C. study highlights rising complexity of hospitalized patients' medical needs

B.C. study details increasing complexity of hospital patients' needs

A recent B.C. study reveals a trend of increasing complexity in hospitalized patients' medical needs, underscoring the challenges facing an aging population and overworked health professionals.

Why it's important: The study, published in JAMA Internal Medicine, shows a significant rise in elderly patients with multiple complex conditions and medications, leading to more ER visits, longer stays and rehospitalizations.

The findings are a wake-up call to healthcare systems across Canada and globally. The rising complexity in patient care demands a more integrated and proactive approach, involving primary care and multidisciplinary teams, including pharmacists and physiotherapists, given the growing pressures of an aging population.

This ongoing shift challenges the traditional reactive healthcare model, emphasizing the need for robust community care services and better management and prevention of chronic diseases. It's crucial for policymakers to recognize and address these evolving needs now to prevent further burnout among healthcare workers.
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B.C. study shows prescribed opioids reduce overdose deaths

A person injects hydromorphone.

A(nother) B.C. study demonstrated that prescribing opioids to people with addiction reduces overdose deaths by 61%.

Why it's important: This evidence counters political criticisms and suggests prescribed safe supply can be a vital part of addressing the overdose crisis.

The study, published in the BMJ, is pivotal in the ongoing debate over the effectiveness of prescribed opioids as safe supply. The findings that these prescriptions significantly lower the risk of overdose deaths provide strong evidence against political rhetoric that has often overshadowed scientific data in this discussion.

This research calls for a more sophisticated and evidence-based approach to the overdose crisis, challenging the prevailing narratives that often hinder the implementation of harm reduction strategies. The study's implications are important for policymakers, healthcare providers and patients, emphasizing the need for a more compassionate and pragmatic approach to addiction and overdose prevention. It is essential to shift the focus away from politicized arguments to evidence-based solutions that prioritize the health and safety of people struggling with addiction.
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Canada firm on protecting domestic drug supply against U.S. importation plans

Health Minister Mark Holland asserted Canada will not permit the U.S. or any other jurisdiction to threaten its pharmaceutical supply, following FDA approval for Florida to import Canadian drugs.

Why it's important: This stance is crucial for safeguarding Canada's drug supply against potential shortages due to bulk exportation to the U.S., ensuring Canadians' continued access to necessary medications.

Holland's declaration comes as a reassurance to Canadians that their access to essential medications will not be compromised by foreign demands. While the U.S. struggles with high drug prices, Canada's priority appears clear: safeguarding our own drug supply. The decision to limit the export of drugs at risk of shortage reflects a proactive approach to the FDA announcement and to healthcare management.

Holland's upcoming discussions with U.S. officials will be crucial in navigating this delicate diplomatic and economic issue. The federal government's decision appears to show a commitment to protecting our national health interests over and above allowing the U.S. to skirt around its own domestic drug pricing regulations.
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As always, thanks for joining me this week.

Your dedication to staying informed keeps our broader health community vibrant and knowledgeable. If you have questions or thoughts to share, I always enjoy hearing from readers. Whether you’ve been here from the beginning or recently found us, don't hesitate to drop me a line at [email protected].

Until next time, stay curious and informed!

Yours in health,

Nick Tsergas
National Health News Editor
Canada Healthwatch
[email protected] | canadahealthwatch.ca

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