Province's senior care plan not coming quickly enough, says Horizon head

The CEO of the province's largest health authority says the Gallant government isn't moving quickly enough to relieve the burden of seniors who aren't sick, but are stuck living in hospitals for months at a time.

At least one hospital, the Upper River Valley Hospital in Waterville, now has half its beds being used for "alternative level care," the term for seniors who need to be in nursing homes but who can't get a spot.

Another hospital, the Miramichi Regional, has reached 40 per cent. Overall, one-quarter of the beds in Horizon are occupied by around 400 seniors and others waiting for nursing home or special care spots.

Horizon Health CEO John McGarry told reporters that despite government promises to address the situation, it's not moving fast enough.

"No, if they were, we wouldn't have 25 per cent of our population in ALC," he said.

"It's not done overnight, but I think it's possible to make decisions quickly so we can start planning for it," McGarry said.

Horizon has been studying the idea of shifting beds to deal with the problem. The ALC beds might be moved to smaller hospitals to free up patient beds in larger hospitals, where the lack of beds makes it difficult to schedule surgeries.

Even that process would take nine to 18 months, McGarry said, which is why Horizon would like to get started.

The only alternative we have … is to put the patient out on the end of the driveway.- John McGarry, Horizon Health CEO

"Everything takes longer than you expect, but I don't think anyone in the province would say we've moved fast enough to keep up with the aging demographic," he told reporters. "To say so would be not right, not true."

McGarry's comments came after he appeared before the Legislature's Crown corporations committee.

Hospital beds were a recurring theme for the committee all week. On Wednesday, officials from the province's other regional health authority, Vitalité, defended their proposal to cut almost a hundred beds.

They told the committee they can cut the beds because of lower rates of hospitalization, and because "efficiencies" will reduce the need.

Horizon not cutting beds

But Friday, McGarry said Horizon isn't ready to make the same move because there is nowhere to send ALC patients.

"Until such time as there are appropriate structures out in the community, there's no point in saying we're going to cut beds," he said. "The alternatives aren't there."

He wouldn't comment on the Vitalité plan except to say that RHA has "a different environment, different needs, and different infrastructure in place. Their plan, I'm sure, reflects what will work best for them."

On Wednesday, PC MLA Madeleine Dubé suggested Vitalité was cutting beds under pressure from the Liberal government. CEO Gilles Lanteigne said that wasn't the case.

She said Friday Horizon's hesitation to cut beds quickly supports her theory that Vitalité "redid their plan" in response to Liberal pressure.

McGarry told MLAs on the committee that the health authorities should have some "influence" over nursing home system.

"It wouldn't hurt to bring the two together. We would like to have more influence in nursing homes, homes, special care homes, not to run them necessarily, but to have more influence."

He said "we're trying to work out situations and we can't work them out" partly because nursing homes operate under a different government department.

No alternatives for care for seniors

Green party leader David Coon, a member of the committee, said it was "extraordinary" that half the beds in the Upper River Valley Hospital are being used by people who don't need hospital care.

"What strikes me is the human element of having to live in a hospital when you're not sick," Coon told McGarry. "That's your home."

The CEO agreed. Given the infection risk in hospitals, he said, "having someone live in a hospital for 12 months when they should be living somewhere else is not safe."

But, McGarry said, "the only alternative we have … is to put the patient out on the end of the driveway and say `we're done with you, there's nothing more we can do for you.' And that's not very palatable."

McGarry also discussed Horizon's announcement this week that it will close or reduce hours at its hospital cafeterias, which lost $350,000 last year.

He told the MLAs that running money-losing cafeterias amounts to subsidizing meals for staff and visitors, when that money should be going to patient care.

McGarry told PC MLA Jeff Carr that the move was not the result of government pressure.

"We always have pressures from governments because they give us our budgets and they tell us we are not to incur a deficit," McGarry said. "That's pressure enough. They don't need to fine-tune it anymore than that."