Ontario will have to make “tough decisions” to address the challenges facing the province’s health-care system, which is decentralized and lacks accountability, according to the first report from Premier Doug Ford’s health advisory council.
The interim report released on Thursday by the Premier’s council on improving health-care and ending hallway medicine, chaired by Rueben Devlin, outlines in broad strokes the issues plaguing the province’s health-care system, but does not make recommendations on how to remedy them. That will come in a follow-up report to be released in the spring focused on solutions, Dr. Devlin writes in his introductory letter to Mr. Ford and Health Minister Christine Elliott. The group, comprised of 14 doctors and advisers, will also hold round-tables across the province.
“Tough decisions will be required to address the challenges facing our health-care system, while we continue to champion the health care professionals already leading great work in our communities,” Dr. Devlin writes.
Mr. Ford appointed Dr. Devlin, a former Progressive Conservative Party president and CEO of Humber River Hospital, in July to chair the new council aimed at improving health-care by offering advice to the government, a position that came with a $348,000 salary plus paid expenses.
The report comes amid discussion about whether the Ontario government is planning to restructure the health-care system, including whether to close the 14 local health integration networks (LHINs), which are the bureaucracies overseeing health-care at the local level. The Toronto Star and the CBC have reported that the government is taking aim at the LHINs.
In a chapter called “Responsibility and Accountability in Health Care,” Dr. Devlin writes that a “lack of integration” leaves the health-care system “decentralized, large and siloed,” making it difficult to know who is responsible and accountable to patients.
“This is in part due to the size of the system," Dr. Devlin writes. “There are currently 21 health-related government agencies supporting the design and delivery of health care in Ontario. Many of these agencies were created to tackle specific problems, support research, or to establish quality standards and metrics to help the system as it matured.
“However, these agencies are not always well-aligned and there is limited strategic oversight to ensure the efficient and co-ordinated use of resources.”
Ms. Elliott told reporters on Wednesday that Dr. Devlin’s report contains preliminary information about what he has heard so far.
“We are looking forward to continuing to work with him. He’s bringing forward some very helpful insights,” she said.
The report outlines how a lack of support for patients in their communities and a dearth of spaces in long-term care leads to overcrowding in hospitals and so-called “hallway health-care,” a term used when patients are put in an unconventional or unexpected location to wait for a hospital bed. According to figures cited in the report, in November, 2018, only 34 per cent of people admitted to hospital go to an inpatient bed within eight hours. The wait for a bed in long-term care is 146 days, the report says.
Findings say patients and families have difficulty navigating the health-care system, which faces capacity pressures and lacks effective co-ordination. Dr. Devlin said his council will also focus on technology-based solutions.
“Simply adding more beds to the system will not solve the problem of hallway health care,” the report said.