Why Doug Ford's hospital funding will not end hallway healthcare

When Premier Doug Ford and his health minister announced short-term funding for hospitals last week, his publicity machine trumpeted the news as solving the problem of patients languishing in hallways. 

"Ending hallway medicine once and for all in this province," says Ford in the opening clip of a video by Ontario News Now, produced by PC Caucus Services — staff who work for the party's MPPs, creating partisan communications material and doing research.

"Putting an end to hallway healthcare," declares the "reporter" for Ontario News Now. "Ontario's government for the people is securing 1,100 new beds to help ease hospital gridlock across the province," she continues. 

• Ford government offers $90M to boost hospital bed numbers
• More than 4,300 patients spent time in hallways at Brampton Civic Hospital last year

But the reality of the 1,100 "new beds" is that they will not end hallway healthcare. They are a temporary addition: one-time funding of $90 million to cope with the annual flu season, designed to handle the surge in demand for beds that occurs every winter.

Adding beds that will soon be filled by the extra patients hospitalized this winter does nothing to solve the overcrowding choking the system right now.

This time last year, the previous Liberal government made an almost identical announcement: one-time funding of $100 million to add 1,200 beds to handle surge capacity during flu season. That move was widely dismissed as doing little to ease the chronic overcrowding.

"Hallway health care will not be solved overnight," said Anthony Dale, president and CEO of the Ontario Hospital Association, responding to Ford's funding announcement. 

"Ending hallway medicine will require significant long-term investments in hospitals and across the continuum-of-care," said the OHA, the umbrella group representing the management of the province's hospitals, in a brochure published ahead of the election. "No matter which party is elected in June, now is the time for urgent action on health care." 

• Ontario reopens shuttered hospital sites as flu season looms
• Code gridlock: What one of Ontario's busiest ERs reveals about hallway healthcare

The Ford government's injection of flu season beds could be seen as urgent action, but it is clearly not the kind of long-term investment that the OHA has in mind to solve the capacity problem. 

Here are three key numbers about hospital funding and beds to put the latest announcement into context:  

• $18.8 billion: province's hospital funding in 2018-19 budget.

• 20,000: number of acute-care beds in Ontario hospitals.

• 15 per cent: proportion of beds occupied by patients waiting for an "alternate level of care."

The final figure is particularly important. This means there are some 3,000 patients occupying acute care beds who don't need to be there. This is a significant factor in the overall capacity crunch throughout Ontario's hospitals, forcing patients to spend days on stretchers in hallways or wait hours in the emergency rooms. It is not a new phenomenon. 

An alternate level of care (ALC) patient is someone who has been "medically discharged" from the hospital but is still occupying a bed, because the care they need outside of hospital is not available. In many cases, these are older patients waiting for a long-term care space, while some are waiting for a rehab bed or adequate home care.

To put it simply, one of the best ways to end hallway medicine is to create more (less expensive) long-term care beds, freeing up spots in (more expensive) acute care. 

• Ontario needs 10,000 long-term care beds in next five years, says association
• All three provincial parties promising more long-term care beds

The Ford government appears to have taken a step toward doing that, announcing it is "moving forward with building 6,000 new long-term care beds across Ontario." 

But much is unclear about those beds. What is the timeline? When will construction start? When will they be available for people to move into? Do these include the 5,000 long-term care beds that the Liberal government announced last year to be built by 2022?

Ford and Health Minister Christine Elliott refused to take questions, despite inviting reporters to the announcement. There were no answers in the government's woefully thin news release. Health Ministry staff referred all questions about the announcement to Elliott's office. 

"Different long-term care spaces will proceed at different paces depending on the stage of planning," said Elliott's press secretary Hayley Chazan in an email Friday.

"Generally speaking, it can take up to three years for beds to open once a project is approved."

 She did not answer a question about whether this includes the 5,000 long-term care beds that the Liberals already announced. 

• Doug Ford has been in office 100 days: These are his biggest moves so far  

The government was similarly thin on the details of the 1,100 beds for the flu season surge. Officials said some would turn into permanent beds, but could not say how many. Nor could they say how many of the 1,200 surge beds funded under the Liberals last year are still operating. Nor could they provide a list of how many beds would go where. 

A list of where the beds will go is not too much to ask. Last fall, the government provided this breakdown, including names of hospitals and precise numbers. 

It seems some PC MPPs got specific information last week that they used to toot the government's horn.  

Finance Minster Vic Fedeli tweeted that 26 beds are coming to North Bay Regional Health Centre, in his riding of Nipissing. But when contacted by CBC News, officials at hospitals in Sudbury, Timmins and Sault Ste. Marie said they had not received specific details about bed numbers. 

There is one thing you can be sure of in the wake of this announcement: the stories of patients being housed in the hallway, in the TV lounge, or in the bathroom at Ontario's hospitals are far from over.