A Foreword By Niagara At Large
The late Canadian prime minister Pierre Elliott Trudeau once said that the United States is a great place to live if you are young, healthy and wealthy.
One of the matters Trudeau was focusing on when he made that comment was the lack a publicly funded, universal system of health care in the U.S. – the kind of which Canadians have been blessed with now for the better part of 50 years, thanks to the progressive campaigning of a politician named Tommy Douglas.
But thousands of cuts by successive provincial governments, starting with the NDP government of Bob Rae, the Conservative governments of Mike Harris and Ernie Eves, and now the Liberal government of Dalton McGuinty, along with the mismanagement of hospital services by unelected, regional boards like the Niagara Health System, Canada’s system of accessible, quality care for all appears to be heading for its death throes – in this region of the country, at least.
Unelected bodies like the NHS and the Local Health Integration Network (LHIN) for the Niagara and Hamilton regions of the province continueclosing patient beds in our hospitals while the provincial government tries wiping its hands clean of any responsibility.
Niagara At Large has posted many articles on this site – articles you can scan by y visiting www.niagaraatlarge.com – on citizens’ continued concerns over the mess being made of hospitial services on the Ontario side of the border. And below, we are posting a note by Fiona McMurran, a Welland resident and Niagara representative for the citizens group, Council of Canadians, followed by a report from the Ontario Public Service Employees Union (OPSEU), representing more than 600 health care professionals in Niagara’s hospitals alone.
Please read them and seek out contact information for your provincial representatives, the province’s premier and health minister, and tell them enough is enough. Remind them there is a provincial election next year and a price will be paid for those who sit back and let unelected boards systematically dismantle our health care services.
No here is the comment from Fional McMurran and report on bed closings from the Ontario Public Service Employees Union.
A Comment From Fiona McMurran
Oh, the good news just keeps on coming, doesn’t it?
The Director of Care of the seniors’ residence where my elderly Dad lives (in the Ottawa area, since his hospitalization earlier this year, who has 30 years experience as a nurse, told us that in Ottawa, patients who stubbornly refuse to die within a three-week period are sent back to their own homes or to long-term care homes, rather than “clutter up” hospital and/or palliative care beds.
What have we come to in this province?
OPSEU Report – Hamilton-Niagara Region Loses 181 complex Care Beds In Faulty “Right-Sizing” Plan
Fifty-eight more complex care beds are scheduled to close after the Hamilton Niagara Haldimand Brant Local Health Integration Network (HNHB LHIN) approved a plan that will take “continuing” out of “complex continuing care.” That brings to 181 the number of complex care beds that have been cut since last December.
Under the new plan complex care patients will be limited to those seeking between 45 and 90 days of care, including those seeking end of life care.
The HNHB LHIN claims it is right-sizing the number of beds based on a formula that takes into consideration the number of alternate level of care (ALC) patients occupying the beds, an adjustment for population growth, a calculation of unmet need, and an assumption that 92 per cent of the beds will be occupied at any one time. The task force does not give us the data in which they made these calculations.
Instead of looking at average occupancy to determine present use, the LHIN task force simply took a one-day snapshot which indicated 590 complex care (CC) patients were occupying beds. These patients fit the new definition of complex care, and therefore would not include ALC patients.
At present there are 686 beds available. 590 patients represent an 86 per cent occupancy rate – considered by many health administrators to be full occupancy. Yet somehow the report also claims between 35 per cent and 38 per cent of the beds are occupied by ALC patients. How could that be, given it adds up to 121 to 124 per cent?
At 92 per cent occupancy, CC patients would occupy 577 beds based on the new target of 628 beds – that’s 13 beds less than their one day snapshot. In addition, if they calculated for a five per cent unmet need, based on 590 patients, they would need to find an additional 29.5 beds. They claim their calculations also include population growth. Unless “growth” was negative, this definitely does not add up.
The task force neglects to report on what the average length of stay presently is for a complex care patient. Given they knocked “continuing” out the title, one would expect many of these patients to be long-term. What happens to these patients is never defined.
How the LHIN and the hospital determine which CC patients are ALC is an interesting question, given new criteria for overall admission to CC includes completion of the acute phase of illness, completion of the major portion of diagnostic tests, and the fact that the patient is no longer requiring acute daily medical intervention by a physician. This is very similar to the definition of ALC.
The report also redistributes beds by sub-region within the LHIN. The biggest loser would be the Niagara region, which would lose 41 beds. This compounds other losses under the Niagara Health System. Hamilton would lose 24 beds and Brant would lose 18 beds. Burlington would gain 23 beds while Haldimand-Norfolk would gain two beds – just months after cutting 10 complex care beds.
The plan also envisions a greater role for the Community Care Access Centres, which are to provide assistance to hospitals in placement of individuals currently designated ALC into more appropriate settings. However, with no new long term care beds and home care at capacity, it is unclear where the CCAC would be placing these individuals.
The task force needs to give us the complete formula on how they made their calculations. A back of the napkin calculation would suggest there is a reason the numbers have not been filled in on the report – it’s because they don’t add up.
(Click on Niagara At Large at www.niagaraatlarge.com for more news and commentary on matters of interest and concern to our greater binational Niagara region.)