Ontario’s new plan to move elderly hospital patients into long-term care homes not of their choosing won’t alleviate the current challenges facing the health care system, critics say.
The province says the new legislation, dubbed the “More Beds, Better Care Act,” is intended to free up hospital beds and reduce wait times in crowded emergency waiting rooms. Long-Term Care Minister Paul Calandra has said the new policy will also provide better living arrangements for patients who no longer need the level of care provided in hospitals.
But opposition politicians and advocates for long-term care patients argue the government’s plan will not address these staffing and capacity crunches. Instead, they say, it will simply increase strain on the province’s already overburdened long-term care system. There are nearly 40,000 people on the waiting list for long-term care beds in the province, according to the Ontario Long-Term Care Association, and not enough staff to care for an influx of patients.
Peter Tabuns, interim Leader of the Ontario NDP, warned the plan isn’t going to alleviate pressures on nurses, because the majority of patients waiting for long-term care beds are being cared for by personal support workers, who have different skills and training.
His party is calling for another response to problems in Ontario’s health care system: the repeal of Bill 124, which caps wage increases for nurses and other public-sector workers at one per cent annually for a three-year period. The NDP is also calling for new initiatives to recruit international health care workers and convince retired ones to return to the profession.
“You’re really just rearranging the deck chairs on the Titanic,” Mr. Tabuns told reporters at a news conference Thursday. “You can shuffle people around from one overextended system to the other, but it’s not going to solve the problem we’re seeing in our hospitals and in our emergency rooms.”
Under new regulations outlined on Wednesday, if there aren’t enough beds in patients’ preferred long-term care homes, hospitals are required to send them to different homes. Those homes can be up to 70 kilometres away from the patients’ preferred locations in Southern Ontario.
In Northern Ontario, where there are fewer long-term care homes, the radius is 150 kilometres or patients can be sent to the next closest homes if there are none available in that radius. Patients who refuse to leave hospitals will be charged $400 a day.
These new hospital powers will come into effect on Sept. 21, and the fees will be introduced on Nov. 20.
Jane Meadus, a lawyer for the Advocacy Centre for the Elderly, said the language in the province’s new regulations has her concerned that patients may be discharged from hospitals and sent home without the proper care. Discussion of the legislation has focused on moving patients to long-term care homes, but the regulations say patients discharged for other levels of treatment, such as home care, could also be charged if they refuse to leave.
Ms. Meadus said she doesn’t expect the legislation to open up hospital beds quickly, because there isn’t much space in long-term care homes to accommodate the transferees. The monthly turnover, she said, is only about one or two beds per home. Data from the province as of Aug. 24, show only 2,270 available beds in the long-term care system, roughly three per cent of the total.
“I’m really afraid that they’re going to be pushing people into the community, where they can’t be cared for and they’re either going to die or end up back in the hospital sicker than they were,” she said. “The amount of people this is going to be able to deal with is small. Other people are not going to be able to get their services so they’re going to end up in hospital.”
Ontario Hospital Association president and chief executive Anthony Dale has said he supports the policy because it will open up needed hospital beds. The association is working with Ontario Health to implement the regulations.
Patients in the province are facing record wait times to be admitted to hospitals from emergency departments, according to July data from Ontario Health.
The average wait time was 20.7 hours, and only 24 per cent of patients were admitted within the target time of eight hours. Ten per cent of patients waited more than 44 hours to be admitted. About 97 per cent of acute care hospital beds are currently occupied in the province.
There are more than 6,100 patients in hospital who no longer need the level of care hospitals provide. About 40 per cent of them are waiting for long-term care. The province has said its plan is expected to open up 250 hospital beds within six months, and 1,300 by March, 2024.
On Wednesday, Ontario Health Minister Sylvia Jones said she didn’t want to put a hard cap on the number of beds the new measures would open up. She offered a revised number, 400 beds, but did not say over what period of time they would become available.
Editor’s note: An earlier version of this article incorrectly stated that under new Ontario regulations, hospital patients can be moved to the next closest long-term care home if none was available within a 70 kilometre radius. In fact, the ability to move patients to the closest home outside a certain radius only applies in the North, where the threshold is 150 kilometres.