The CEO of Windsor Regional Hospital says the blame for the net reduction of 86 staff should be placed on the frozen provincial hospital funding over the last five years.
David Musyj of Windsor Regional announced Tuesday there will be a staffing change implemented over the next nine to 12 months affecting 166 positions, the result of a $20 million funding shortfall.
According to Musyj, of those positions, about 120 are registered nurses and 80 of those RNs will be replaced by 80 registered practical nurses. The hospital currently has a total of 1,550 RNs and 180 RPNs across both of its campuses.
Hospital funding for operational costs has been divided between three models since 2012: 30 per cent is covered by what is called global funding; 20 per cent by Quality-Based Procedures; and 40 per cent by Health Based Allocation Model.
Musyj said the problem is with the HBAM, which allows a hospital in Toronto, for example, to receive more funding than a Windsor hospital for performing the same procedures because Windsor has a lower growth projection.
He said this model would work if the overall pool of funding increases at least every two or three years, but it has stayed at approximately $19 billion for the last five years.
“In effect, if you’re funding growth areas from non-growth areas, it doesn’t work,” he said.
To offset these staff reductions, Musyj said the goal is to deal with them through attrition, though he said he is hopeful anyone who wants to continue working will be able to do so.
The hospital typically has a natural attrition rate of five per cent per year, he said. About 3,800 people are employed by the hospital.
Additionally, Musyj and hospital vice-presidents have taken a four per cent salary reduction.
Musyj said most of the staff have known an announcement of this kind would be coming since July. Administrators knew the hospital faced a $10 million shortfall at the end of the 2014-15 fiscal year, but were then notified of an additional $10 million hit in revenue.
The hospital had a surplus or balanced budget for six years prior to its realignment in 2013, which saw the hospital organization taking over operations of its Ouellette campus from Hotel-Dieu Grace Hospital.
Windsor Regional received transitional funding of $7 million for this fiscal year and $5 million for next year from the Ministry of Health and Long-term Care.
“If we didn’t get the funding, the changes would have been immediate and we wouldn’t have allowed this attrition to take place, so therefore it would have exponentially increased the chances of someone who wanted to work here wouldn’t be able to work here,” said Musyj.
One of the ways a hospital can generate new operational funds is through the construction of new facilities. This is why it is “most important for our community” the proposed single-site acute care hospital moves forward, said Musyj.
The replacement of the 80 nursing positions means Windsor Regional’s Metropolitan Campus will move from an all RN model to a mixed model of RNs and RPNs, which is already in place at the Ouellette Campus.
Musyj said the campuses were going to have to standardize their RN to RPN ratios as a result of the 2013 alignment and the proposed new hospital regardless of the funding shortfall.
Karen McCullough, WRH chief nursing executive, said the Ouellette Campus currently has a mix of 83 per cent RNs and 17 per cent RPN, which will be duplicated at Metropolitan.
She said she doesn’t expect any change in death and mortality rates at the hospital.
“You can look at the way we’re delivering our care and make certain that the standards that we have right now, which are incredibly high, have excellent patient-care outcomes at Windsor Regional Hospital,” said McCullough. “There are hospitals in the province of Ontario that once again have excellent outcomes as well and they’re not an all RN model of care either.”
Ontario Nurses’ Association president Linda Haslam-Stroud disagreed in a statement released following the announcement.
“The research and evidence show the devastating impact of RN cuts on patients and our ability to provide safe, high-quality care: excessive workloads, more complications, increased infections, higher morbidity and mortality rates and readmissions, longer wait times and poorer health outcomes,” said Haslam-Stroud.
Windsor West NDP MPP Lisa Gretzky also issued a statement Thursday which said the cuts “will have a real impact on people in their most vulnerable moments.
“The elimination of these positions will be felt in an area with already stubbornly high unemployment,” she said. “Rather than investing in frontline services, the government continues to fail families by forcing our healthcare providers to grapple with a five year freeze in hospital funding.”
Musyj said he’s “more than confident” at least 80 people will retire this year to cover the job losses.
RNs at Windsor Regional start with an hourly wage of $31.01, move to $44.06 at the eight-year mark and then $44.84 at the 25-year mark.
RPNs at the hospital make $27.50 an hour at the one-year mark.