11/15/11

Minister of Health opposes more hospital beds

Sun news article yesterday led with the (correct) observation that "Ontario’s plan to spend billions of tax dollars on hospital construction will not significantly increase the number of beds". Ontario Health Minister Deb Matthews countered as follows :

”It’s not about more beds. In many cases that’s not what the need is. It’s for modern up-to-date emergency departments, operating rooms. The rooms themselves, the patient rooms, in the old hospitals, simply do not meet today’s infection control standards, so the new hospitals have far more single rooms which will prevent things like C. difficile infection...We’ve also offset it (i.e. 18,500 hospital bed cuts -- DA) by more than 10,000 long-term care beds and beds in other settings outside of acute care hospitals.  So there are a lot more beds now than there were but they’re not in acute care hospitals and that’s actually a move in the right direction.”
There are a number of problems with these arguments. Most basically, not all hospital beds are acute care beds.  Far from it.  In fact, there is a major need to develop more non-acute care hospital beds.  But more of that later.  

Second, there is a need for more single patient hospital rooms to deal  with superbug infections, so, if that is what the Minister is getting at in her reference to old hospitals not meeting infection control standards, good!  But there is also expert evidence that superbug infections are connected to high hospital bed occupancy.  And here there has long been nothing but silence from the Ministry.  

Third, far from being an adequate response to hospital bed cuts, the increase in long term care beds only offsets the rapid growth in the relevant population.   In fact, the McGuinty government has been moving away from creating new long term care beds  -- in contrast with the policy of the previous  government.   Moreover, ICES reports that in the six years between 2002-/3 and 2008/9 the number of people in Ontario over 85 increased 36.9%.  That one age group accounts for more than half  of the people in LTC facilities in Ontario.   So it is very little surprise that the wait times for long term care beds have sky-rocketed.

Finally, long term care isn't designed to get people back into their homes.  LTC facilities are homes for people who are no longer able to take care of themselves despite any medical intervention.  LTC facilities must expand to take care of  the growing segment of the population that finds themselves in that predicament.  But LTC facilities do not provide curative beds -- and people only rarely return to their homes once they enter them.  

So to the extent the government does actually want to return people to their homes (as they endlessly claim) they need hospitals beds. That is where people get cured -- or at least made well enough so that, with increased home care, they can return to their homes.  

Very few hospital 'ALC' patients are waiting for home care, but many are waiting for rehabilitation or chronic care in the hospital.  When they get that, then, perhaps they will be able to go home.  We need improved hospital capacity and more home care hours so that more people can go home once they are well enough.

Unfortunately, if the government sticks to its funding plan, we are going to get less of both. 

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