By Stew Slater
New Ministry of Health funding being funnelled to the Huron Perth Healthcare Alliance (HPHA) means the operator of four hospitals in Perth and Huron Counties doesn’t have to be as concerned about a budget deficit. But that doesn’t mean HPHA administrators aren’t still going to tackle a factor that would have contributed significantly to that deficit: a discrepancy in the funding it receives for cataract surgery, compared to how much it costs to perform the operations.
At a meeting Thursday, Nov. 1, members of the HPHA board of directors learned that, effective Sept. 30, the Alliance showed a deficit on this year’s budget of $204,349. That’s significantly lower than a previously-planned deficit for the same date of $600,709.
Typically, the board plans for a deficit early in the budget cycle, in the anticipation that re-adjustments and new initiatives at the Ministry level will eventually bring that deficit towards a balanced state. And this year is not different: also at the Nov. 1 meeting, a report from the Resources Committee stated that about $300,000 was made available “over the original planned base funding amounts,” and the HPHA qualified for almost $700,000 in one-time funding related “primarily to CT/MRI wait times and additional Quality Based Procedures.”
Doing that math on those numbers, however, reveals that, potentially, the HPHA could have found itself in a surplus position already. But that’s not the case. And Resources Committee member Bill Scott, in delivering his report to the board of directors, said the blame falls squarely on the Alliance’s failure to provide cataract surgeries within the provincial funding allotment.
Scott noted only some procedures are funding on this model. On hips and knees, he reported, “we’re doing it for less than (the provincial allotment). So we’re actually making a profit, at least for now.”
Cataracts, by contrast, “are not being performed within the funding rate . . . If changes are not implemented to bring costs into line, HPHA will lose approximately $300,000 in 2012/13.”
Chief Financial Officer Ken Haworth said the provincial rate dropped over the past couple of years from $750 to $497. THe HPHA performs cataract surgery in two of its locations; the average cost in Stratford is $644, and in Clinton it’s $839.
“There are centres in Ontario with one surgeon doing 30 per day,” he said. “In Clinton, we’re doing 18.”
Speaking to reporters after the meeting, Haworth added that about 10 per day are done in Stratford.
Scott suggested the implications are clear: If ways are not found to decrease how much it costs to deliver cataracts under the present model, the HPHA will have to consider either consolidating the procedure in one location, or possibly not doing cataracts at all and asking patients to travel to another centre.
Haworth told the board of directors a working group has been formed, which will seek input about the issue and come up with possibilities for reducing costs.