Ontario is wrestling with delays and shortages of supplies needed for home and palliative care, with dying people unable to get sedatives and patients going to hospital because their supplies have run out, the province’s doctors say.
Health Minister Sylvia Jones said Monday that she and her ministry are working hard to rectify the “frustrating” situation.
“(It) is absolutely unacceptable,” she said in question period.
“We have been working with Ontario Health atHome to ensure that no patients, no patients’ families, no clinicians are impacted by a logistics issue. I want to assure the people of Ontario that we have been on this issue since we first learned that there were shortages. … We know this is unacceptable and we are not going to allow this to continue.”
Jones said she has directed the agency to reimburse any patient, family or clinician who has paid out of pocket for necessary equipment.
Ontario Health atHome said in a statement that it has new supply contracts as of Sept. 24 and it is doing everything possible to stabilize the delivery of critical medical items.
“Ontario Health atHome takes any impact to our patients very seriously, and we understand the distress this is causing,” the agency wrote in a statement.
“We want to assure patients, their families and health system partners that we are doing everything we can to address this situation and are continuing to look for opportunities to stabilize the delivery of these critical medical items.”
Dr. Joyce Cheung, the Ontario Medical Association’s chair of palliative medicine, said palliative care doctors across the province have been raising concerns about medication and supply delays that have sent patients to emergency rooms, and a lack of medication and needles leaving people in pain.
One of her palliative patients went 30 hours without a pain pump, she said, and another patient with metastatic cancer nearly ran out of ostomy bags for collecting stool.
“I don’t know what to do,” she said. “Are people buying supplies off Amazon where we cannot validate the quality of these supplies? We’re hearing these stories. They are ongoing in every corner of the province.”
The province passed legislation late last year to create Ontario Health atHome, in order to better co-ordinate home care across the province. Cheung said physicians were not part of any transition planning when the agency switched to new suppliers this fall.
“We were all taken aback,” she said. “We’re just like, ‘What is going on?’ We’re just seeing what’s happening on the ground, and we don’t even know how to pivot, because we didn’t realize this was going to be such a disaster.”
There were probably good intentions behind standardizing supply contracts, but the implementation has gone awry and it seems as though the vendors did not anticipate the amount of supplies they would need, she said.
“I think there’s going to be some forensics to be done afterwards of what actually happened,” Cheung said. “How can we prevent this from happening again?”
Bayshore Specialty Rx, one of the companies responsible for distribution of the supplies, said a confluence of factors, including unexpected stock issues, impacted their fulfillment system.
“We sincerely apologize to those impacted and we are fully committed to restoring the level of service that Ontario home health care patients deserve,” the company, which operates in the southwest region of Ontario, wrote in a statement.
“Our entire team is focused on mitigating these challenges and ensuring continuity of care for every patient under our services.”
Bayshore said it is restoring and improving tracking systems, dedicating additional staff to manage the distribution of urgent supplies, improving communications and sourcing alternative supplies.
Liberal health critic and emergency room doctor Adil Shamji said the situation is dire, and should have been anticipated.
“When I had a chance to speak with ministry bureaucrats and to debate the legislation that brought forward Ontario Health atHome, it was clear that, apart from knowing what the branding was — specifically that it would be called Ontario Health atHome — they had no other clue about how this centralized, mega agency would actually perform, would actually be able to deliver care for patients who require it from home,” he said.
“They’re scrambling and flying by the seat of their pants.”
NDP Leader Marit Stiles said she wants clear answers as to why this happened in the first place.
“Not only is it unacceptable what’s happening in home care right now, but it’s unethical, deeply unethical,” she said.