There’s no comfort in forced LTC transfers

Recently, several hospital CEOs wrote a letter claiming to provide “comfort and clarity” about Doug Ford’s new Bill 7, the so-called More Beds, Better Care Act, 2022.

We offer a different sort of “clarity” about this bill, from which we derive no comfort.

Bill 7 allows the forced transfer of hospital patients to long-term-care homes not of their choosing. Rushed through without committee or public hearings, the bill will push frail patients into homes up to 150 kilometres away, without their consent. Indeed, Bill 7 expressly suspends the requirement for informed consent; it allows hospital staff to assess patients as “eligible” for long-term care and to share their personal information with any home — without consent.

These facts may not be “comforting.” But they are certainly clear. So, it’s deceptive for the CEOs to “encourage” “informed choices” about which homes “patients wish to go to.”

Bill 7 eliminates choice. Also notso-comforting-but-clear: if a patient refuses a move — to a home too far away for family to visit — hospitals can charge them $400 a day, an amount few can afford.

The CEOs claim, “Hospitals are specialized care environments for acute care patients.” But, in fact, public hospitals provide rehabilitative, mental health, palliative and other care just as important as “acute care.” The implication that “non-acute” patients occupy beds needed for “real” care is discriminatory and ageist.

More: “Our health-care system has been under a tremendous amount of stress, particularly during the pandemic.” But the money that would have relieved that “stress” has been there all along. The Ford government ended this fiscal year with a $2.1-billion surplus, which could have relieved workers who, in despair and burnout, have now left health care.

Yet we’ve seen no letters from CEOs asking Ford to use that surplus to help those workers or to provide more hospital beds, of which Ontario has the fewest per capita of any province. In short, although they could have opposed Ford’s failures of health-care planning, these CEOs instead have decided the consequences of those failures should now be borne by the most vulnerable patients.

As to where “non-acute” patients might go, it’s claimed, “New longterm-care spaces are being built.” But let’s not pretend there isn’t a reason many “spaces” are empty. Compared to non-profits, for-profit homes had higher rates of COVID-19 infections and deaths, spend 24 per cent less on direct care; have fewer staff and lower pay, and fail to deliver on standards of care. While lobbying against regulations to protect residents, owners siphon off revenues to shareholders.

After shielding the worst homes from potential liability, Ford is now rewarding them with public dollars — those he didn’t provide in the years of “tremendous amount of stress” in health care. Homes where no one wants to live, but must be at 98 per cent capacity to receive their full entitlement of government funding.

The CEOs claim, “Long-term care is a much more appropriate and comfortable environment to live.” Comfortable? The “heartbreaking” and “horrifying” conditions of long-term care shocked seasoned soldiers of the Armed Forces: dehydration; malnourishment; cockroach infestations.

The worst conditions were documented in for-profit homes into which, under Bill 7, most patients will be forced, and where Ford has done nothing to improve an unprecedented staffing crisis.

We believe that the assurances of “comfort and clarity” about Bill 7 from hospital CEOs are deeply disturbing. There will be no comfort for patients forced to move to longterm-care facilities that provide substandard care, and far from their families and friends. The only real clarity here is that the Ford government, instead of providing support for a proper health-care system, has chosen to sacrifice its most vulnerable citizens.