Ontario budget to address problem of patients in hospital hallways: finance minister
TORONTO – Ontario’s finance minister says Thursday’s budget will contain funding to deal with the problem of overcrowded hospitals, a situation that has patients being placed in hallways, boardrooms and even cafeterias.
In a recent interview with The Canadian Press, Charles Sousa spoke specifically about the case of Jamie-Lee Ball, whose treatment at Brampton Civic Hospital made headlines and sparked debate at the legislature.
Ball was admitted to hospital March 25 and spent five days on a stretcher in hallways, suffering internal bleeding as the hospital experienced a level of overcrowding it calls “Code Gridlock” – when it has more patients than hospital beds.
“We have to find a better way of dealing with that, and that’s what we’re doing in the upcoming budget,” Sousa said. “We don’t want people to be in hallways.”
The government knows that capacity has been a problem at hospitals all around the province, Sousa said, and wants people properly cared for.
The Brampton hospital has needed to put patients in hallways when its 608 provincially-funded beds and extra surge beds are full, said Dr. Naveed Mohammad, vice-president of medical affairs with the William Osler Health System, which includes Brampton Civic Hospital.
“Every large hospital in the GTA has had to put patients in unconventional places,” Mohammad said. “One of our peer hospitals has had to put patients in their boardroom and in the cafeteria.”
Being in a hallway with only a hanging sheet for privacy left Ball feeling exposed, depressed, discouraged and sleep-deprived, she said.
Ball and her mother have since launched a petition calling for more hospital funding.
“It’s one thing to look at the health care system and determine the most cost-effective budget and another to look at the health care system and realize what funding is needed to ensure Canadians receive the best care possible in the shortest time frame,” Ball said.
According to the CEO of the Children’s Hospital of Eastern Ontario in Ottawa, the problem of patients in hallways comes down to the government’s constriction of hospital funding over past five years.
“It’s a basic math problem,” Alex Munter said. “If you’ve got increasing demand and population growth, but diminishing resources, then something’s got to give – and what ends up giving is capacity.”
Over the past five years, Ontario hospital operating funding has averaged less than one-per cent growth, while inflation and population growth mean that has effectively been a funding cut year after year, said Munter.
The Ontario Hospital Association is calling for a 4.9 per cent increase to hospital funding in the budget. Average bed occupancy rates in Ontario hospitals have risen to 92 per cent – and there is a greater likelihood of risk to patients when the average rate exceeds about 85 per cent, according to the association.
“During flu season, in particular, many hospitals will experience occupancy of up to 130 per cent,” the association wrote in its budget request to the government.
Sousa said he knows hospitals suffered capacity problems in the recent flu season and that played a role in Ball’s case.
Another part of the capacity problem is beds continue to be used by patients who no longer need to be in hospital but are waiting for more appropriate care to be available elsewhere – such in long-term care homes and mental health facilities in their community.
They’re referred to as “alternate level of care” patients and, according to the OHA’s budget request, they make up about 15.5 per cent of patients in Ontario hospitals.
Ontario has been implementing a plan dubbed Patients First to move patients out of hospitals, into less expensive community and home care.
The province has been increasing funding in those areas – including, mostly recently, $20 million announced Tuesday that will go to funding respite for unpaid caregivers who help friends and family members stay at home.
While the hospital association supports the plan to transition more patients out of hospitals, it says the number of alternate-level-of-care patients in hospitals has grown despite those efforts.
“Immediate and concerted action is needed to allow hospitals to meet the growing needs of these complex patients while they remain in their care, and to minimize the impact these patients have on the ability of hospitals to admit patients in need of acute care,” the OHA said.
Fixing the capacity problem requires both operating funding, to lower wait times and fund more beds, as well as capital costs for new construction, according to the OHA.
At a recent event at CHEO, Munter and other hospital administrators questioned Ontario Premier Kathleen Wynne about how much financial support her government will provide in the budget.
Tammy DeGiovanni, Director of Ambulatory Care at CHEO, told Wynne that recent years have been tough on the hospital and it has found all the efficiencies it can find – right down to saving on postage.
Wynne said the province has heard those concerns clearly.
“We know that we need to support you,” she said. “We know that you need resources in order to do that.”