Ontario's major hospitals are overcrowded, operating with 100 per cent of their acute care beds occupied, sometimes trying to squeeze in even more, creating potential hazards for patients and leading to inadequate care, according to documents obtained by the New Democratic Party.
The Thunder Bay Regional Health Sciences Centre calls the situation "Code Gridlock" – when there are not enough beds to accommodate all of the patients. According to the documents, released Monday by the Ontario NDP, occupancy has exceeded 100 per cent for two of four quarters in each of the past two years at the Thunder Bay facility.
At Toronto's Hospital for Sick Children (SickKids), for example, during one quarter in 2013-14 and one in 2014-15, the occupancy rate was above 100 per cent; at the London Health Sciences Centre – University Hospital site, there were 10 consecutive quarters where the occupancy rate exceeded 100 per cent.
The story is even worse at the Rouge Valley Health System – Ajax and Pickering site, where there was a preliminary occupancy rate of 118.5 per cent for the first quarter of 2015-16, according to the Ministry of Health documents obtained through a Freedom of Information request by the NDP.
Ontario NDP Leader Andrea Horwath has been pushing the Wynne government for weeks over concerns about health care cuts – and was at it again during Question Period Monday, painting a grim picture of what goes on in the province's hospitals as a consequence of those cuts.
"This Liberal government has forced many of our hospitals to operate at over 100 per cent capacity," Ms. Horwath charged. "That means long wait times for patients in the [emergency room] because every bed in the hospital is already full. It makes it harder to control the spread of infection, and it puts pressure on cleaning staff. It means that patients end up being treated on stretchers in hallways because there is no room left in the hospital."
The Organization for Economic Co-operation and Development (OECD) says an 85-per-cent occupancy rate is safe. That is the occupancy rate in Britain.
The documents also reveal that the ministry does not have "standards, guidelines, policies, or best practices with respect to hospital bed occupancy as it relates to hospital relations."
Deputy Premier Deb Matthews defended the rates, arguing that Ontario's health care system is in transition, and is "about building more capacity outside of our hospitals."
"We still have too many people in hospital who do not need to be in hospital, who do not want to be in hospital," she said.
The Ontario Health Coalition's executive director Natalie Mehra says that Ontario has the fewest beds left per capita of any province in Canada; in the OECD, only Chile and Mexico have fewer hospital beds.
"The overcrowding is unheard of," Ms. Mehra said. "It's not safe. It causes more violence in the hospitals, it causes more infection rates. It means there is not enough staff per patient."
In a submission last January to the Ontario finance committee, Ms. Mehra cited statistics from the Canadian Institute for Health Information that showed in 2008-09, Ontario had 2.5 beds per 1,000 population. That has now decreased to 2.3 beds; the other provinces have an average of 3.5 beds for the same number of people.
She said the Ontario government has cut more than 18,000 hospital beds since 1990.
"This hospital cuts regime is the most radical in the country," she said in an interview Monday. "It's damaging. Every service that is cut is privatized … the scope of public medicare is shrinking."
She also noted there has been no research on how many beds Ontario has or are needed since a study by the Progressive Conservatives under Mike Harris in the mid-1990s.
But health policy expert Steven Lewis says it's a complicated issue. "The occupancy rate is distinct from overcrowding although obviously they are related," he says. "If you have a hospital with all beds full but no stretchers in the hallways and no temporary multibed rooms that weren't intended as such, it will be full but not overcrowded."
If, he notes, the hospital has enough staff for a higher occupancy rate, then patient care should not be affected.
"Hospitals are inherently risky places for infections and if patients are placed in proximity to others whose conditions may put them at risk, indeed, there could be a problem," he added.