The Hamilton Spectator
Prescriptions for an ailing health system
It appears as if Ontario’s ailing health-care system is suffering from a nightmare of concurrent disorders.
Shuttered emergency rooms. A dearth of family doctors. Long waiting lists for surgeries and specialists. All while foreign-trained health professionals struggle to work while denied accreditation.
Meanwhile, looming over this unhealthy brew is a provincial government that shows signs of looking to exploit the crisis to privatize health care. Already, Premier Doug Ford has moved to allow more for-profit clinics to provide OHIP-covered cataract and other surgeries along with diagnostic procedures.
His recurring drumbeat that “we know the status quo is not working” or “we have to start thinking outside the box” sounds in seems to be laying the groundwork for a lurch toward more private-sector involvement. The deeply skeptical even suspect that allowing the creation of a crisis was a necessary first step for garnering public support for drastic measures.
Prime Minister Justin Trudeau has said his government will ensure the Canada Health Act is honoured and that he would not hesitate to claw back or withhold funds in cases where its guarantee of universality is not met.
What is clear is that the front-line of health care may be in worse condition than previously feared.
A report by Torstar’s Kenyon Wallace showed an alarming number of hospital emergency departments in Ontario — especially in rural areas such as Alexandria, Perth and Smiths Falls, Campbellford, Chesley, Seaforth and Kemptville — were closed in the last year due to a lack of staff.
Wallace found that ERs in 24 hospitals were closed 158 times in the past year, resulting in the equivalent of 184 days when the urgent-care needs of many communities could not be met.
Appalled advocates said the closures of ERs put the health and lives of people in those regions at risk.
“Those numbers are astounding,” said Dr. Rose Zacharias, president of the Ontario Medical Association and an emergency physician. “This is wrong. This is not doing right by our patients.” She said the number of days when an ER is closed “should be zero.” It could hardly be put more plainly.
The anxiety of being unable to access emergency care when urgently needed is both inhumane and unacceptable.
Beyond the ER crisis is the shortage of family doctors who would lighten that ER load.
Recently, Inspire Primary Health Care reported that about 2.2 million Ontario residents were without a family doctor, the critical first point of contact for relatively minor matters to help keep patients out of ERs, and the gateway into the complex world of medicine for major concerns.
The provinces recently accepted the federal government’s proposed $46.2-billion increase in health-care spending over 10 years. Details are to be worked out in bilateral agreements. Ottawa has earmarked $25 billion for improvements in four key areas: family health services, health workers and backlogs, mental health and addictions, and a modernized health system.
The emphasis has been on creating primary-care teams that include nurses to co-ordinate care and offer clinical support, mental-health workers to provide psychological and addictions counselling and connect patients with social supports, and clerical and support staff.
The Ontario College of Family Physicians has reported that about 75 per cent of family doctors function without such teams.
It’s hoped that the new money promised by Ottawa, used wisely, will help alleviate these challenges and making family practice a more attractive option for medical students.
It would also surely help to keep ERs and family doctors’ offices open if the qualification process for foreign-trained doctors was improved and expedited.
So, there is lots that can and must be done to remove some of the risk and anxiety from the lives of Ontario citizens.
It’s essential, in such extraordinarily trying circumstances, for Ontarians to insist on improvements, acknowledge there is no magic cure and be aware that the remedies will involve a menu of solutions, not just the addition of private-sector clinics.