Ontario hopes to ease healthcare pressures by increasing publicly covered surgeries in private clinics, waiving screening and registration fees for internationally trained nurses, and sending patients waiting for a long-term care bed to a home not of their choosing.
On Thursday, Health Secretary Sylvia Jones announced the plan, which aims to hire more health professionals, free up hospital beds and reduce surgical waiting lists. The plan comes as a shortage of nursing staff has caused emergency departments across the county to close all summer for hours or days at a time.
In terms of long-term care, the government is today planning to introduce legislation that would allow bed-waiting patients to be moved into a “temporary” home while they wait for a place in their preferred home. It also has 300 beds that have been used for COVID-19 isolation and made available to people on waiting lists, and it says there is potential to do so with an additional 1,000 beds within six months.
The Department of Health and Long-Term Care has confirmed to CBC Toronto that 200 people who have been in hospital for six months awaiting LTC beds will be transferred over the next three months, with a total of 1,300 transferred by March 2023.
However, Long-Term Care Minister Paul Calandra said the legislation would not force anyone who did not want to leave hospital to go, nor would it make “any changes to the priority waiting list”.
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Calandra also said the legislation would “allow us to continue talking” about temporarily moving patients home when they no longer need hospital care but their preferred long-term care home is not yet available.
“The changes allow us to continue that conversation to explain to someone in the hospital why their needs can be met in a long-term care home,” Calandra said.
Critics say the changes won’t solve the underlying problem
But Frances Gilinas, the NDP’s health critic, said the county would be better off beefing up the home care system with more full-time personal support staff.
“Giving people a choice of where they want to be is respecting them,” she said. “Now, hospitals will have the right to put a lot of pressure on you and your family to get you to the first available bed, not the bed you choose… This is disrespectful, and this is not the way healthcare should be.”
Gélinas suggested that the first available beds would likely be “in a private for-profit house”, some of which were subject to A scathing military report of the year 2020 After suffering from some of the county’s worst coronavirus outbreaks.
In the county document, there is a reference to “mandatory guidelines used by staffing coordinators to ensure patients continue to remain near a partner, spouse, loved one, or friend.”
While the new investments provide important resources and financing to the sector, Donna Duncan, CEO of the Ontario Long-Term Care Association, says it is not enough to address the day-to-day employment challenges facing all homes, particularly in rural areas. and remote communities.
“To support safe admission from the hospital, we need to ensure our homes have the health human resources and other workforce in place, especially as we transition into the anticipated fall/COVID flu season,” Duncan wrote.
The association says it represents nearly 70 percent of Ontario’s 630 long-term care homes, in a mix of private, not-for-profit, charitable and municipal environments. Duncan says the association is facing an LTC waiting list of nearly 40,000 people, with seniors “in need of high-quality care close to loved ones and their communities.”
“All health sectors are facing severe workforce shortages, and we are all looking to recruit from the same pool of health professionals available,” Duncan said.
A greater role for services provided by the private sector
The county plan outlines a greater role for privately provided but publicly covered services, as the government says it will invest more to increase surgeries at existing children’s hospitals and private clinics covered by OHIP. It is also studying options to increase surgical capacity by increasing the number of such procedures being performed in “independent health facilities”.
Jones said Ontario needs to be “bold, innovative and creative” when looking for ways to improve the health system.
“There are those who will fight for the status quo, no matter what,” she said at a press conference announcing the plan. “They are ideologically opposed to change or improvements. We will not accept that. We cannot accept that. People want better health care.”
Jones did not directly answer a question about whether she would consider allowing more private clinics in Ontario.
“Health care will continue to be provided to Ontarians through the use of your OHIP card,” she said.
Nurses Association opposes further privatization
Catherine Hoy, president of the Ontario Nurses Association, has criticized the plan to increase services in private clinics.
“This is a scandalous move that will fill the pockets of investors, nothing more,” she said in a statement.
“The evidence is clear: health care privatization delivers worse health outcomes for our patients and much higher overhead costs for taxpayers. Ontario is diving deep into privatization that will only benefit shareholders.”
Hoy described it as “puzzling” that the plan also outlined steps to support emergency department doctors, but not nurses.
“The government missed a huge opportunity here to boost nurses’ compensation as key to retention and employment to limit additional closures,” she said.
In a statement, liberal health critic Dr. Adel Al-Shamji described the plan as “a series of empty promises” that showed the government “has not learned any lessons from the pandemic.”
The MPP said the Secretary of Health “rather than ignoring her responsibility to strengthen our publicly funded healthcare system by asking the for-profit sector to solve problems,” she should offer real solutions that address the root causes of the severe stress facing our healthcare system. “
Viable solutions include creating a “strong nursing workforce by repealing Law 124,” Shamji said, along with increasing funding for community and primary care operations that would reduce emergency department visits. Until then, he said, “this crisis will continue to spiral out of control.”
Ontario is expanding a program that sees physicians from across the province helping hospital workers in northern and rural communities, launching a new program to provide support and training from emergency physicians to rural emergency departments, as well as introducing a new program that connects resident physicians with physicians in northern and rural emergency departments.
Ontario to cover some nurses’ fees
The county will temporarily cover exam, application, and registration fees for retired and internationally trained nurses, saving them up to $1,500, and plans to invest up to $57.6 million over three years to increase the number of nurse practitioners working in long-term care homes.
Jones said she expects a plan today from both the College of Physicians and Surgeons of Ontario, as well as the College of Nurses of Ontario, on how they intend to expedite applications for those professionals still awaiting certification and licensing in Ontario.
The College of Nursing plan includes provisional enrollment of thousands of internationally trained nurses.
The county’s plan also includes modifying a program that can deploy full-time nurses across multiple hospitals in the area, and expanding a program for mid- to late-career or retired nurses to mentor new nurses.
“There are a lot of pieces that are part of this plan that haven’t been finalized,” Jones told reporters.