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