Skip to main content

Are cuts forcing hospitals to push patients out illegally?

With the cuts to Ontario hosptials, high bed occupancy has become commonplace, forcing hospitals to cancel surgeries and introduce hallway medicine.  The Waterloo Record reports that Ontario hospitals have become aggressive about getting seniors out of hospital beds and raises questions about whether the actions of the hospital are even legal.  Some key facts reported by the Record:


  • Many hospitals have developed policies encouraging patients to accept the first long-term care bed that becomes available, with hefty fees threatened for those who don't comply.
  • Experts question whether high-pressure policies are ethical, or even legal.   Health Ministry managers, hospital officials and elder advocates who met in 2008 to examine first-available-bed policies concluded they "have no basis in legislation."
  • Policies "often differ from hospital to hospital and are developed and applied in an inconsistent fashion across the province," the group said in a report of their proceedings, obtained by Metroland. In certain cases, actions that resulted from such policies "may contradict" law, the report said.
  • Jane Meadus, a lawyer for the Advocacy Centre for the Elderly, argues that many hospital policies break the law by "constraining" the patient's right to choose freely - including requirements to choose homes with short wait lists, or by "placing unlawful pressure" on patients to choose a home they don't want.
  • If a nursing home bed becomes available and a patient refuses to leave the hospital, officials can charge a much larger fee, a per diem or "full daily rate." (Toronto Baycrest is an example of a hospital with a formal policy: a fee of $1,745 a day applies to patients who refuse an available nursing-home bed. Baycrest, however, has "yet to encounter a situation" in which the fee was levied, a spokesperson said.)
  • The Ontario Hospital Association says provincial law allows a per-diem to be charged if a patient can be safely discharged from an acute-care bed, but refuses to leave. The Ministry of Health says per diems are not regulated. The Public Hospitals Act gives hospitals the authority to levy fees, but does not specify how much can be charged.
  • Toronto-based Advocacy Centre for the Elderly surveyed Ontario hospitals in 2007 on their discharge policies, and 38 responded. "The threat of a per diem is made in the discharge policies of 89.5 per cent of the hospitals who responded to the survey," the centre said, noting that fees ranged from $277 to $827 a day.


     The full story can be found at: http://news.therecord.com/News/article/728325

Comments

Popular posts from this blog

Ontario long-term care staffing falls far short of other provinces

CUPE and others are campaigning for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care (LTC) facilities.  New research indicates that not only is LTC underfunded in Ontario, it is also understaffed compared to the other provinces. 
LTC staffing falls short:  The latest data published by the Canadian Institute for Health Information (and based on a mandatory survey undertaken by Statistics Canada) indicates that staffing at long-term care (LTC) facilities falls far short of other provinces. 
Part of this is driven by a low level of provincial funding for LTC.





Ontario has 0.575 health care full-time equivalent employees (FTEs) per bed staffed and in operation.[1]  The rest of Canada reports 0.665 health care FTEs.[2] The rest of Canada has 15.7% more health care staff per bed staffed and in operation than Ontario.[3] 


No other province reports fewer LTC health care staff per resident (or per bed) than Ontario.[4]

Occupancy r…

More spending on new hospitals and new beds? Nope

Hospital funding:  There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities).   

For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year.  But, this is just a notional increase from the previous announcement of future hospital capital spending. 

Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period.

So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more than they have ann…

Health care funding falls, again

Real provincial government health care funding per-person has fallen again this year in Ontario, the third year in a row.  Since 2009 real funding per-person has fallen 2.6% -- $63 per person. 

Across Canada real per person funding is in its fourth consecutive year of increase. Since 2009, real provincial funding across Canada is up $89 -- 3.6%.
In fact the funding gap between Ontario and Canada as a whole has gown consistently for years (as set out below in current dollars).

Ontario funds health care less than any other province -- indeed, the province that funds health care the second least (B.C.) provides $185 more per person per year, 4.7% more.  
Provincial health care spending in the rest of Canada (excluding Ontario) is now  $574 higher per person annually than in Ontario. 

 Ontario has not always provided lower than average health care funding increases-- but that has been the general pattern since 2005.
Private expenditures on health care have exceeded Ontario government increases …