Home Care Ontario | Dec 19, 2017
Hamilton Spectator-December 18, 2018
A Hamilton-based advocacy group says improved home care is what's needed to alleviate provincewide hospital overcrowding.
Home Care Ontario says it can help rescue overwhelmed hospitals from "the brink" following warnings from the sector that it is "under significant pressure" and facing "an imminent capacity crisis."
The Ontario Hospital Association raised alarm in a submission for the 2018 budget that "Without action, patients will wait far too long in the emergency department and may even be redirected elsewhere because there simply isn't any room."
A big part of the reason for the crisis is a lack of home care services, says Sue VanderBent, CEO of Home Care Ontario located at 175 Longwood Road South.
"We have not invested enough in home care to grow the system adequately," she says. "As a result the home care system has been trying to accommodate by making visits shorter and shorter in order to see greater numbers of people."
The harder it gets to provide the care, the more difficult it is for the home care sector to recruit and retain staff.
"Hospital overcrowding in my opinion is directly linked to home health care human resource issues," said VanderBent. "We have a shortage of home health care staff."
Home Care Ontario will be making its own submission to the government asking for six per cent of the $53.8 billion the province spends on health care which works out to around $3.2 billion.
Home care currently gets about five per cent of the budget or roughly $2.7 billion.
"That number really hasn't changed to accommodate the growing numbers of elderly, the complexity of the care and the hospitals which have also become more acute," said VanderBent. "As a system, we're starting to feel the effects of trying to do it all on the same thin dime."
Hospitals are also looking for a significant increase of 4.55 per cent in total operational funding as well as the creation of a fund to modernize infrastructure and equipment that is rundown, at the end of its life or outdated.
"Ontario's hospitals are on the brink," said Anthony Dale, president and CEO of the Ontario Hospital Association (OHA). "As they are planning for the next fiscal year, many are staring at some extremely significant challenges. This is the consequence of years of austerity, a relentless drive toward improving efficiency and the need to build up capacity outside of the hospital setting."
Dale agrees that a better home care system is a key part of the long-term solution to hospital overcrowding.
"That capacity just doesn't exist yet," he said. "Until we see the revolution that is needed in home care and in long-term care, hospitals need a bridge strategy to get them through this very challenging period."
It's a significant issue considering Ontario's hospitals never recovered from last flu season so they are already bursting at the seams as influenza returns.
"The surge that often happens with a flu season exposed the very tight and high occupancy levels hospitals are facing," said Dale. "What's very worrisome is it returned in the summertime. None of us in the OHA or most observers in the health care system have seen that before."
The occupancy rate at St. Joseph's Healthcare was as high as 139 per cent for non-surgical beds in August revealed the Ontario NDP, which released overcrowding numbers Wednesday obtained through the province's Freedom of Information and Protection of Privacy Act.
In fact, the occupancy rate for medical beds dipped below 125 per cent only once in the entire month — it was Aug. 30 and the rate was still a staggering 121 per cent.
"It's a totally unsustainable situation," said Dale. "It's not the quality of care that patients should expect because of the congestion and increased waiting times. It affects the people who work in hospitals — that level of intensity isn't sustainable for anyone over a long period of time."
The province provided some relief in October with $100 million to make more than 1,200 additional hospital beds available across Ontario and $40 million for post-hospital and preventive care at home.
However, the funding for the new beds runs out March 31 and the number of beds isn't enough to solve the problem. While St. Joseph's got funding for 36 more beds from the province, it is still so overcrowded that it is operating an additional 21 unfunded beds.
"When our hospitals are saying, 'We're doing nursing in the hallways,' it's not the hospitals' fault, it's a systemic issue," said VanderBent. "We have to get ahead of this. Suddenly there is a tipping point where the wheels start to fall off and that's when we're in deep water."
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