Lobbying LHIN for glaucoma funding instead prompts
Central LHIN's response to local efforts to lift the funding hard cap
on specialized glaucoma surgeries at Stevenson Memorial Hospital in
Alliston, is a list of "eight highly skilled Ophthamology surgeons" who
perform the operations at the Kensington Eye Institute in Toronto.
The doctor referral was provided by Kim Baker, Central LHIN CEO, in a
letter dated October 21 to Ursula Martin, a patient of Dr. Baseer Khan
in Alliston, (also listed among the eight doctors) who has been
lobbying hospital, LHIN and senior politicians to find more funding for
additional eye surgeries at SMH. Ms. Martin, who lives in Barrie, told
Ms. Baker that she learned "(rather cruelly), that the hospital only
budgeted for 45 Glaucoma Surgeries for the fiscal year."
"I urge the Central LHIN to take immediate action to continue funding
the Hospital and its excellent staff to provide these urgently needed
medical procedures," wrote Ms. Martin. "Stevenson Memorial has invested
considerable resources in equipment and staff training, how can this
all be allowed to fade away when so many people need the services?"
"You may not be aware that funding for glaucoma surgeries at Stevenson
Memorial comes from the hospital's global budget, which is determined
by the Ministry of Health and Long-Term Care and overseen by the LHIN
through Hospital Service Accountability Agreements," replied Ms. Baker.
"The amount allocated to surgeries like glaucoma is determined by the
hospital's leadership as part of the annual budget planning. It is the
LHIN's understanding that Stevenson is striving to best respond to the
needs of its community while operating within its global budget."
Last spring, for the first time since ophthalmology was expanded at SMH
in 2006, glaucoma surgeries were hard capped as part of the broader cut
by LHIN to fund only 300 cataract surgeries, down from 419 performed
the previous year, in Alliston.
Dr. Khan, one of only a few specialists in the province who perform
Complex Glaucoma Surgeries, was informed last spring that his cap would
be 105 cataract surgeries, and 45. Between April 1 and June 30, he had
performed 60 glaucoma, including "other" procedures. In September Dr.
Khan was informed he could book 81 more cataract only procedures.
Any more would have to come from the hospital's global budget, and
SMH's board of directors determined that because the majority of
patients were from outside the hospital's catchment area, that they
were no longer going to fund more than 45 surgeries.
In a statement from Central LHIN to Free Press Online, the point is
reiterated that the funding cap is a decision the hospital made.
"So, the amount allocated to surgeries that aren't Quality Based
Procedures (QBPs) - like glaucoma - is determined by the hospital's
leadership as part of the annual budget planning. As a point of
clarification, cataract procedures are classified as a QBP and the
number of annual cases is determined and capped by the Ministry of
Health and Long-Term Care.
It is the LHIN's understanding that Stevenson is striving to best
respond to the needs of its community while operating within its global
budget, and that they have engaged their community since 2011 to help
determine their strategic priorities.
By way of context, Ontario's health care system is moving away from a
global funding system to a model that primarily follows the care that
patients need and will be provided to them. This means that a small
portion of the overall budget remains as global to cover facility level
operating costs. You can learn more about funding reform on the
Finally, it's important to note that LHIN boundaries are for management
and administrative purposes only. Our borders allow us to look at the
specific needs of our region but should not impact doctor referral
patterns. This means that patients should be able to receive care from
the doctor of their choice, even if that means traveling to another