In a bid to ease the shortage of hospital beds with the winter COVID-19 and flu season approaching, Premier Doug Ford has used his majority to give hospitals more power to push frail and elderly patients cleared for discharge into nursing homes not of their choosing.
Bill 7 — known as the More Beds, Better Care Act — was introduced 13 days ago and passed Wednesday amid warnings from critics it could result in seniors being moved to homes that are far from their families or that fared poorly in terms of illnesses and deaths during the pandemic.
“The long-term-care homes with the most available beds are the ones with the worst records of caring for seniors,” said New Democrat MPP Wayne Gates (Niagara Falls), his party’s long-term care critic.
Ford insisted the almost 2,000 elderly in hospitals on waiting lists for long-term-care beds would be better off in nursing homes, even if the facilities they are sent to are not on the list of five preferred homes they have selected.
“It’s about giving proper care to people who should be in long-term care,” Ford told the legislature’s daily question period before the vote.
Opposition parties said the legislation — which Ford did not mention during the June 2 election campaign that saw him returned to office with a bigger majority — was rushed with no legislative committee hearings or public hearings.
“The government is ramming Bill 7 through today with virtually no debate,” said interim NDP Leader Peter Tabuns.
Long-Term Care Minister Paul Calandra has said no patients will be physically moved without their consent but encouraged hospitals to use powers in place since 1979 to charge the elderly the $62 daily long-term care co-payment if they refuse the move to a nursing home.
There is also the prospect patients refusing to consider long-term care or other facilities once cleared for hospital discharge could face daily uninsured hospital bed rates of as much as $1,800, although Ford signalled Tuesday night that could change.
“We’ll have to work on the cost.”
The lack of specifics as the bill was passed raised concerns, with Tabuns citing “fees the premier has not figured out or is not willing to reveal.”
Interim Liberal Leader John Fraser said the bill sets the stage for “coercion” of the vulnerable elderly into places they do not want to go to avoid paying additional fees.
“The premier and any member of this legislature, any of us here, would not want any of our family members having to do something without their consent.”
Ford said the status quo is no longer an option given overcrowding in hospital emergency rooms, some of which have had temporary shutdowns this summer because of a lack of staff, and backlogged surgeries from the pandemic.
There are now 6,000 patients in Ontario hospitals, including almost 2,000 awaiting nursing home beds, who no longer require acute care but are waiting for alternate levels of care (ALC), which could include home care or rehabilitation facilities.
Critics have slammed the government for not doing enough to boost those alternatives, resulting in the current situation, and noted long-term-care homes are also experiencing severe staff shortages from the pandemic.
Reports from a commission into long-term care during COVID-19 and military medical teams called into several homes where staffing levels fell as low as 20 per cent during peak periods of infection found the sector was not ready for the pandemic.
A military report described as horrendous conditions such as residents dehydrated, force fed to the point of choking or left in soiled diapers for hours or days, crying for help.
Meanwhile, several groups called on the Ontario Human Rights Commission to “undertake a formal investigation into systemic discrimination in the provision of health care in Ontario against the elderly based on age.”
“Bill 7 will profoundly exacerbate the discrimination and disadvantage that elderly patients — and their families — experience today,” said a statement from the Ontario Health Commission, the Advocacy Centre for the Elderly and the Ontario Council of Hospital Unions.
“Under Bill 7, a patient designated ALC may be moved to a long-term-care home without their consent,” the groups added.
“If they resist transfer, they may be charged a fee of hundreds or even thousands of dollars for every single day they remain in hospital. The Ford government has refused to provide clear and detailed information about how the new provisions would be implemented.”
While the NDP and Liberals say they have heard from insiders that distance guidelines for putting the hospitalized elderly in nursing homes under the bill may be no more than 300 km from a patient’s home in northern Ontario, 100 km in the south and 30 km within cities, the government has said consultations are underway and details will be specified in regulations to be developed after the legislation is passed.
“No family should have to go through this,” said New Democrat MPP Peggy Sattler (London West), noting families are integral to care of loved ones in nursing homes and long distances will be a barrier to visits that are essential for the mental health of residents.
Rob Ferguson is a Toronto-based reporter covering Ontario politics for the Star. Follow him on Twitter: @robferguson1