The Ford government is facing growing pressure to clarify how a new health care law could affect Ontario families as it would allow patients to be moved from hospital to a long-term care facility that does not choose or potentially face high daily costs.
The spotlight comes just as the government moved a motion to advance the bill straight to third reading, meaning it will not be considered by committee or subject to a public hearing at that stage.
Long-Term Care Minister Paul Calandra introduced Bill 7 last week. The legislation would give hospitals the authority to temporarily move patients who no longer need acute care to long-term care homes chosen by a placement coordinator. Hospitals would have to make “reasonable efforts” to obtain patient consent, but the text of the bill says it could be done without consent if necessary.
The legislation has come under scrutiny this week from opposition parties and some health experts, who have expressed concern about its vague wording and questioned how it could ultimately affect patients and their families
“The government hasn’t given any clarity. And they’re talking about moving people, possibly away from their families and their support. You know, we’re not moving livestock around here, it’s not livestock. They’re people. They’re vulnerable, there’s no cattle.” said interim Liberal leader John Fraser at Queen’s Park this morning.
Fraser and fellow Liberal MP, Dr. Adil Shamji, held a press conference to show their own concerns about Bill 7 and encourage the Progressive Conservative government to withdraw the bill as written.
“It’s actually cruel that the government is being so vague. There’s no reason for it,” Fraser said.
Interim Liberal Leader John Fraser called on the Progressive Conservatives to hold committee hearings on the bill or withdraw it. (Chris Young/The Canadian Press)
The bill is part of a wider plan first announced two weeks ago by Health Minister Sylvia Jones to help ease pressures on the health system. The proposed changes aim to hire more healthcare professionals, free up hospital beds and reduce surgical waiting lists as emergency services across the province close their doors for hours or days at a time due to shortages of staff
A particularly controversial element of the legislation is exactly what steps hospitals could take if patients refuse to be transferred to a long-term care home they did not choose. The legislation does not allow patients to be physically forced to move, but it is unclear what would happen if a patient refuses to be moved.
How hospitals can charge patients
In an interview with CBC Radio’s Metro Morning on Thursday, Dr. Samir Sinha, head of geriatrics at Sinai Health and the University Health Network in Toronto, explained how the current system works.
Patients list several long-term care homes they would be willing to move to after they no longer need hospital care, he said. If the patient is accepted to one of these facilities but can’t be transferred immediately, the hospital will charge about $62 a day in the interim, the same amount of copayment the patient would face for care long-term.
If the patient who is deemed no longer in need of acute care refuses to consider alternative facilities for care or to move after being accepted to one of their preferred long-term care options, add a hospital network spokesperson, a hospital can formally discharge them and bill the uninsured daily rate.
That can be $1,500 or more per day.
“Often the discussion about the cost of staying in an acute care bed is enough to start the discussions needed to support someone in a [alternate level of care] environment,” said UHN Senior Advisor for Public Affairs Rosa Kim.
Metro Morning 8:15 Charging older patients to leave hospital bed for long-term care will leave vulnerable people behind: Dr Samir Sinha
Dr. Samir Sinha is director of geriatrics at Sinai Health and University Health Network.
The current text of the legislation is unclear, however, if a long-term care facility chosen by a placement coordinator for a patient then becomes a preferred option, even if the patient has no interest to go there
CBC Toronto has reached out to the Ministry of Long-Term Care for more information.
During a scrum at Queen’s Park on Wednesday, Calandra supported hospitals that charge uninsured daily rates to patients who refuse to be transferred to a facility of their choice, saying the beds are needed for others.
“If someone refuses to move into a home, if someone refuses to move into a home of their choice, then yes, should a hospital charge them? Absolutely. Because we need these spaces for patients who they need acute care. We need them for surgery, we need them for emergency,” he told reporters.
Fraser said the looming threat of a hefty bill shouldn’t be used to coerce patients into long-term care homes they didn’t choose.
“The government needs to say, unequivocally, that this is not going to happen,” he said.
what comes next
The bill is currently in second reading. No committee meetings have been scheduled to collect public input on the matter.
Sinha said he is already hearing from concerned patients and their families about what the bill could mean for them going forward.
“They’re scared. They’re worried,” Sinha told CBC Radio’s Metro Morning on Thursday.
Because the proposed bill could theoretically see patients moved to long-term care facilities not of their choice, without their consent, or face crushing daily fees, it would leave many families in “horrendous situations Sinha said.
“This will only strain relationships and create less trust between health professionals and their patients, between hospitals and patients.”