Let’s have true long-term think­ing in health care

The Niagara Falls Review - - OPINION -

Ear­lier this week, the On­tario gov­ern­ment, which has been rain­ing prom­ises on the elec­torate for months, pledged to cre­ate thou­sands more long-term beds and in­crease the time de­voted to di­rect care of frail peo­ple in health fa­cil­i­ties.

It was part of a grandiose 20-point plan, dubbed “Ag­ing with Con­fi­dence,” that we are meant to con­clude will make real in­roads in deal­ing with the 32,000 peo­ple on wait lists for long-term care homes. Be­tween now and 2021-22 (that is, well af­ter next June’s elec­tion), 5,000 new beds will spring up; in the next decade, a to­tal of 30,000 are to be cre­ated.

The Liberals’ good in­ten­tions shouldn’t be dis­missed, but this ap­proach is prob­lem­atic on many lev­els. First, no one re­ally knows if 30,000 added beds, a decade from now, will suf­fice. Sec­ond, the av­er­age num­ber of care hours in LTC homes cur­rently varies widely; in Ot­tawa, it’s thought to be 2.6 hours a day of di­rect care for pa­tients in city-run homes, be­low the 3.1 hour-a-day av­er­age in other area homes, and well be­low the four-hour-aday av­er­age the prov­ince is vow­ing as part of its vague fu­ture plan. Can Ot­tawa, then, count on a pile more health care work­ers? No an­swer.

More deeply, though, the gov­ern­ment’s quick prom­ise re­veals ut­terly boxed-in think­ing: If the cur­rent sys­tem isn’t serv­ing our frail cit­i­zens, well then, let’s just do more of it. Rather than re­visit from the ground up how we can best re­solve our de­mo­graphic dilemma; rather than, for in­stance, plug­ging some of the shock­ing gaps in home care; let’s keep fol­low­ing the path we are on, a path we know has not sat­is­fied any­one.

On Thurs­day, On­tario’s pa­tient om­buds­man, Chris­tine El­liott, re­leased her first re­port, and in it she points to an over­all health sys­tem that is any­thing but pa­tient­based. In gen­eral, the sys­tem is rigid, and of­ten blind to the real peo­ple it looks af­ter. Nowhere is that more true than with the el­derly.

Which is why, in­stead of fling­ing quick fixes at this cri­sis, the Liberals should heed NDP Leader An­drea Hor­wath and call a proper in­quiry into long-term care in gen­eral. They’re al­ready planning one in the case of El­iz­a­beth Wet­t­laufer, the nurse who killed eight peo­ple in three dif­fer­ent nurs­ing and re­tire­ment homes. Hor­wath has fre­quently re­quested that the in­quiry be widened to cover all as­pects of long-term care. She’s al­ready reached some con­clu­sions of her own that we dis­agree with, but she is right that a fresh look and fresh ideas are over­due.

That, we be­lieve, would en­cour­age true long-term think­ing.

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