TORONTO - Ontario's Liberal government wants more routine medical procedures performed in not-for-profit clinics instead of in more expensive hospitals, Health Minister Deb Matthews announced Monday.
It would be more cost effective and result in better patient outcomes if some procedures were done in a non-hospital setting, Matthews said in a speech to the Toronto Board of Trade.
"If we can get faster access for patients, if we can get high quality at a lower cost, (and) take pressure off hospitals so they can use those operating rooms for procedures that do need to be done in hospitals, then this is the way to go," she said.
Officials said clinics could do more MRI and CT scans, X-rays, ultrasounds, dialysis, mammograms and bone mineral density tests so hospitals are freed up to do more work that only they can do.
The Ontario Medical Association, which represents doctors, said physicians could do procedures such as colonoscopies, cataract surgery and some knee operations in clinics instead of hospitals.
"Cataracts is a good example where with volume they can decrease the cost per procedure and then reinvest that money into other health-care agenda items," said OMA President Dr. Stewart Kennedy.
"We can decrease the waiting list and provide (the service) at a cost that is cheaper than we can do in the hospital."
The Liberals' action plan to rein in health-care spending also includes more power for Local Health Integration Networks, said Matthews.
The LHINs, which administer funding to hospitals and community care access centres and to co-ordinate health care in each region, will be given responsibility for family doctors as well.
"It will make it easier for your family doctor to play the co-ordinating role between health care providers, both inside and outside of hospitals and long-term care," said Matthews.
The Progressive Conservatives say the LHINs are a needless level of bureaucracy set up to buffer the Liberals from unpopular decisions, and take money out of front-line health care to feather the nests of well-paid administrators.
"I think they should play no role because they have been a waste of taxpayers' money," said Opposition Leader Tim Hudak.
"They built up little empires of bureaucrats paying themselves over $100,000 a year. They're not doctors. They're not nurses. They're not surgeons. They're a waste of money."
The New Democrats also questioned why the Liberals would expand the role of LHINs when the government still hasn't done a promised five-year review of the agencies due in 2010.
"They're going to expand the powers and responsibilities of the LHINs to take over family doctors without ever doing the review that they promised to do," said NDP critic Cindy Forster.
"I can tell you in my area of the province, the Niagara region, the term LHINs is a dirty word, so I'm not confident in expanding the powers of the LHINs without having the review."
The health minister promised to make doctors more available for after-hours care to stop people from going to hospital emergency rooms, but couldn't say how she would make that happen.
"This is part of the agreement we're going to have to negotiate with doctors," said Matthews.
"We need them working at times that patients need them, and when we have thousands upon thousands of patients going to hospital ERs when the care they need could be provided by their family doctor, we need to get that balance right."
The OMA said doctors already work long hours, but admitted patients aren't always getting appointments as quickly as they'd like.
"We do have to do a better job of seeing patients in a more timely fashion," said Stewart.
Matthews also indicated the government will be holding the line on funding for doctors' salaries and hospitals, warning the province must put more resources into community-based care, especially to help elderly people live in their own homes as long as possible.
"A one per cent increase in physician compensation could buy home care for 30,000 seniors," Matthews told the business audience.
"And a one per cent increase in hospital budgets could buy over five million more hours of home care."
Matthews also announced a new seniors strategy to provide better quality care at home, and the creation of a special council to reduce Ontario's 20 per cent childhood obesity rate by 20 per cent in the next five years.
The province wants to rein in the annual increase in health spending to three per cent a year from more than double that figure in each of the past eight years to help trim a $16-billion deficit.
Ontario spent $47.1 billion on health care in the past year, about 42 per cent of all government program spending.
