Skip to main content

Long-term care beds falling well short of need

The Auditor General reports that the stock of long-term care beds in Ontario has grown only 3% since 2004-5.  Over seven years (until 2011-12) that means an annual average growth rate of  0.42% (or about 319 beds per year).


Photo: Derek Tyson
That falls well short of population growth.  But much more important, it falls far short of the growth of the relevant population - the elderly.  Or as the Auditor General demurely states:  "An increase in the number of LTC home beds of 3% during that period has not kept pace with the rising demand from an aging population."

Ontario Ministry of Finance figures indicate that in the five years between 2006 and 2011 the number of people 85 and over increased 34%.  By 2016 the plus 85 set will have increased by 67% over 2006 -- and the ratio of those 90 and over compared to those between 85 and 90 will have increased from about 50% to 70%.

With a 1.5% annual increase in the number of LTC beds, the Conference Board estimates Ontario would be 127,000 beds short of need by 2035.  

But to fall "only" 127,000 beds short of need, we would have to increase the number of new LTC beds by more than three times the current rate!

The Liberal government constantly talks of dealing with these sort of problems by moving resources from "institutions" to home and community care -- and unfortunately the media has too often innocently bought this line as a panacea.  But the sorts of demographic changes we are facing swamp any such wishful thinking.  Home care can and should be  expanded -- but it can't completely offset  the increasing need for long-term care and hospital services.   

What makes this all the more vexing is that the 'increased' home care funding the government brags about hardly offsets the impact on existing home care services for population growth, inflation, and aging -- never mind making up for the real squeeze on hospital and long-term care services. 

Notably, we are beginning to see sharper measures to curtail the use of long-term care by the government.  The Auditor General notes that the government reduced the wait list for LTC in 2010 by redefining who is eligible for it. There are also reports of hospitals refusing to discuss LTC options with patients or fill in application forms.  

As public home care services are inadequate, the squeeze on LTC will force more elderly people to pay for their own private care, through private retirement homes or private home care.  Paying for private long-term care in the home or in facilities is an unaffordable business for individuals (that's why we have a public insurance system). Some won't be able to afford any such care and many others will be challenged to make do with inadequate care.  

Increased need for more volunteer assistance from family members (especially women) is going to happen too.  

Comments

Popular posts from this blog

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 …

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…

Six more problems with Public Private Partnerships (P3s)

The Auditor General (AG) has again identified issues in her annual reportwhich reflect problems with Ontario health care capacity and privatization.   First, here are six key problems with the maintenance of the 16 privatized P3 ("public private partnership") hospitals in Ontario:
There are long-term ongoing disputes with privatized P3 contractors over the P3 agreements, including about what is covered by the P3  (or “AFP” as the government likes to call them) contract.The hospitals are required to pay higher than reasonable rates tothe P3 contractor for  maintenance work the contractor has deemed to be outside of the P3 contract. Hospitals are almost forced to use P3 contractors to do maintenance work the contractors deem outside of the P3 contract or face the prospect of transferring the risk associated with maintaining the related hospital assets from the private-sector company back to the hospitalP3 companies with poor perf…