The Ontario government has passed contentious legislation that will allow hospitals to temporarily enroll discharged patients into a long-term-care home against their will.
The Progressive Conservative bill, known as the More Beds, Better Care Act, has faced significant criticism since its introduction, with all opposition MPPs voting against the legislation on Wednesday. Seniors’ advocates are concerned the new powers could result in a patient awaiting long-term care being transferred to a home far away from their families or that suffered high death rates from COVID-19 – or face expensive charges if they refuse.
Premier Doug Ford has defended the legislation, which stops short of allowing hospitals to physically move someone, saying it’s necessary to address the pressures on the province’s health care system by freeing up hospital beds for those who need them. There is a record of 5,930 alternate-level-of-care (ALC) patients – meaning they no longer require treatment in hospital – of whom 2,000 are waiting for long-term care.
According to the government, the new policy will open up 250 hospital beds in the first six months, with 1,300 hospital beds freed up this way by March of next year. Mr. Ford said transferring patients to a long-term-care home will allow them to get better service as they wait for their home of choice and reduce the amount of time people are waiting in emergency rooms for a hospital bed.
“They’re going to get much better care in a long-term care facility than sitting in a hospital bed,” the Premier said during Wednesday’s Question Period.
Samir Sinha, director of geriatrics at Sinai Health and the University Health Network, said he’s worried hospitals will focus on using this power to ease the capacity burdens they’re facing rather than putting the priority on the well-being of patients. Dr. Sinha said he will be taking more caution when signing off on the discharge of patients if there is a possibility they could be sent far away from their caregivers.
“I think a lot of hospitals … are simply going to use the new blunt instruments they have to just move people along like cattle,” Dr. Sinha said. “If I with the stroke of a pen say a person is now an ALC patient, if they’re hospitalized and potentially waiting, they could become a victim of this process.”
In a statement, Ontario Hospital Association president and chief executive officer Anthony Dale said the association will be working with Ontario Health and other stakeholders to develop “standardized provincial tools” to support the bill’s implementation, and that the current guidance on transitions out of hospital care is expected to continue to serve as the foundation of any new plan.
On Wednesday, three advocacy groups called on the Ontario Human Rights Commission to conduct an inquiry into what they charge is “systemic discrimination” against seniors. In a letter, the Ontario Health Coalition, Advocacy Centre for the Elderly and Ontario Council of Hospital Unions took issue with the government fast-tracking the legislation by skipping the public-hearing process.
OHRC spokesperson Adewonuola Johnson said in an e-mail to The Globe and Mail that the organization was “monitoring” the situation surrounding the bill, but could not offer further comment.
Critics are also concerned as to how far a patient could be transferred and if they will face hefty fees if they don’t consent to moving. Hospitals currently have the power to charge patients the uninsured overnight rate for refusing to go to a particular long-term-care home, which could be upward of $1,800 a day.
Despite saying last week that hospitals should use the powers currently available to them, Long-Term Care Minister Paul Calandra said in Wednesday’s Question Period that claims of huge fees are “obviously not the case.” On Tuesday, Mr. Ford told reporters that $1,800 is “absolutely ridiculous” and costs would still need to be worked out.
Regulations on distances or fees aren’t included in the bill, but Mr. Calandra said more details will be provided within a week. The bill will need to receive royal assent before coming into effect.
Official Opposition NDP Interim Leader Peter Tabuns said the bill’s passing is “devastating” and his party will continue to call on the government to withdraw the legislation and instead take other actions to address health care challenges, including repealing the wage cap on public-sector workers and speeding up the accreditation of internationally-trained nurses.
With a report from Jake Kivanc
Our Morning Update and Evening Update newsletters are written by Globe editors, giving you a concise summary of the day’s most important headlines. Sign up today.