A majority of Ontarians are uncomfortable with Ontario Premier Doug Ford’s move to allow jammed hospitals to enroll elderly patients who no longer need acute care in nursing homes without their consent, a new Nanos Research poll conducted for The Globe and Mail suggests.
Asked about the Progressive Conservative government’s new policy, which was fast-tracked through the legislature without public hearings, 58.4 per cent of Ontarians said protecting patient rights was more important than easing pressure on hospitals, with 29.3 per cent choosing the latter. Across the country, 55 per cent of Canadians chose patients’ rights, with 33 per cent saying easing hospital pressures was more important.
Respondents were asked: “The Ontario government recently announced a new policy that will allow hospitals to send patients who are awaiting a long-term care spot into a long-term care home that is not of their choosing, without their consent. The government says this will ease pressure on hospitals, but critics warn it could infringe on patient rights. What is more important today, easing the pressure on hospitals or protecting patient rights?”
The national survey, conducted by telephone and online between Aug. 27 and 29, had a sample size of 1,073 and is considered accurate within plus or minus three percentage points, 19 times out of 20. The Ontario-only results, with a sample of 373 Ontarians, have a margin of error of plus or minus 5.1 percentage points, 19 times out of 20.
Ontario’s legislation, passed on Aug. 31 and known as Bill 7, has sparked a bitter debate as the province’s hospitals suffer staff shortages that have forced the temporary shutdown of emergency rooms.
The measures would give hospitals new powers to temporarily enroll some of the around 2,000 elderly patients who no longer need a hospital bed into a temporary long-term care spot they did not choose, without their consent. Reasonable efforts must be made to secure consent, the legislation says, and patients cannot be physically removed.
The government and hospital administrators say the changes are needed to free up much-needed beds, as hospitals face record numbers of this kind of patient waiting to be discharged.
Opposition politicians and advocates for the elderly have warned the legislation will see vulnerable people moved into substandard nursing homes far from their families. They cite examples of hospitals using existing powers to charge people $1,500 a day or more for refusing to move. Mr. Ford has called that number “ridiculous” but still said fees could be involved. Regulations that would govern the new process, and how far away an alternate home could be, have not been released.
Nik Nanos, founder and chief data scientist of Nanos Research, said the poll numbers show “a significant level of unease” with sending patients to long-term care homes without consent.
“This is really a non-starter,” Mr. Nanos said. “... Canadians generally recoil at being forced at a lot of things. People at least need to be provided the opportunity – they need their consent – in order for something like this to happen.”
Jake Roseman, a spokesman for Long-Term Care Minister Paul Calandra, said in an e-mail that most other provinces already have “first-bed policies” for discharging this kind of patient.
“Bill 7 will help Ontario catch up to the regulatory frameworks already in place across the country,” Mr. Roseman said. “This will ensure our health care system can continue to work for all those who need it.”
Interim Opposition NDP Leader Peter Tabuns said the poll numbers echo the response he has heard from the public about Bill 7. He said many are anxious about forcing loved ones into long-term care after thousands died of COVID-19 there and military personnel sent to several Ontario homes at the height of the pandemic told of widespread neglect and unsanitary conditions.
“People don’t want to feel that they would be pushed out of a hospital bed into a long-term care facility that either ensured that they were isolated from their family or was being run by an operator whose reputation was terrible,” Mr. Tabuns said.
Mr. Ford has repeatedly said that hospital chief executive officers support the move.
A prominent leader in the hospital sector says most in hospital awaiting long-term care would be better off in an alternative nursing home and that their beds are desperately needed.
Elderly people stuck in hospital tend to decline more rapidly, said Kevin Smith, chief executive officer of University Health Network, which includes Toronto General, Toronto Western and the Princess Margaret Cancer Centre, as well as long-term care facilities.
“I think the government has got a bit of a raw deal on this,” Dr. Smith said. “Hospitals have been asking for this for 20 years.”
Dr. Smith said fees or charges would only be used as last resort for patients or families who are “intransigent.” Hospital staff would aim to accommodate concerns about the location or suitability of a temporary, alternative long-term care spot, he said.
“I don’t want to charge a single patient. I want to move the patient to the right level of care,” Dr. Smith said, adding that one of his own parents was initially transferred temporarily from a hospital into a long-term care home that was not a first choice.
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