Hospital capacity an issue long before COVID-19 pandemic: experts

Hospital capacity has hit a crisis point in Ontario and it's the main reason for the return of sweeping lockdown restrictions. Adrian Ghobrial with what can be done to fortify our hospitals in the months and years ahead.

By Adrian Ghobrial and Meredith Bond

With the Omicron variant leading to a surge in hospitalizations and staff shortages, hospital capacity is reaching a critical point.

Experts say even before the COVID-19 pandemic, it was clear Ontario was ill-prepared to deal with a health care event of this magnitude. Many agree it was not just the fault of our current provincial government, although they did not help the state of health care.

“The reality is, we have been growing beyond what our health care system is able to meet,” said University of Toronto Professor Jillian Kohler with the Leslie Dan Faculty of Pharmacy.

“What we’re seeing is absolutely failed policy, not just from the provincial government, certainly not helped by this government, but also from past governments as well as the federal government,” Kohler added. “A lot of the problems we’re witnessing today were in the making for years and years.”

Canada currently has one of the lowest rates of acute care beds per 1,000 people within the Organisation for Economic Co-operation and Development (OECD), which collects data on its 38 member countries.

Only Sweden, Colombia and Chile have fewer beds per capita than Canada at 1.9 per 1000 people.

Kohler said there are a lot of factors that can explain “why we are where we are,” but more recently, she says the provincial government’s decision to “initiate massive cuts in the health care sector” before the pandemic is a big part.

She also referenced Bill 124, which caps public sector employee salary increase to one per cent over the next three years. Nurses’ unions have been highly vocal about how this bill contributes to the province’s severe shortage.

“Right now, unfortunately, we are seeing all the bad decisions, all the lack of investment, all the problems of the past are alive and well today when we’re seeing our hospitals and our hospital staff stretched beyond their capabilities,” said Kohler.

In the GTA, she says the situation within the health care system is “unsustainable” due to the number of people with complex health care needs.

“There’s an ageing population that needs care, and simply we just don’t have enough resources to manage our population’s needs. And when you throw in a critical global pandemic, that just again brings everything to the forefront in terms of the instability of our health care sector,” explained Kohler.

Ontario Liberal leader Steven Del Duca acknowledged this isn’t just the current government’s fault. “This is a challenge that’s about 20 or 30 years in the making, cuts across governments from virtually every political stripe…because there’s been an emphasis on this notion of efficiency rather than on resilience.”

Del Duca called for bipartisanship when dealing with the health care system and said they should be focused on hearing from the frontline workers to find solutions.

Dr. Melanie Bechard, Chair of Canadian Doctors for Medicare, tells CityNews, this is an excellent opportunity for Canada to look at the health care system. However, she doesn’t believe it should be a debate about public versus private health care funding.

“I don’t see any benefit to having more private funding to this system. If people think that we’ll suddenly be able to decrease our surgical waitlist simply by building more private clinics. My question is, how are you going to staff them?” asked Dr. Bechard.

“If you take staff who are currently working in the public system to work in a private pay system, you’re probably going to make the wait times longer for the vast majority of the population, which is what we’ve seen in other nations when they’ve gone to more of a two-tier system.”

She said her fear for the future is that people will be motivated more by a political ideology, leading to a system that creates more private options for care.

“I really hope that Canadians and policymakers take this as an opportunity to look at how we do things within our publicly funded health care system, how to appropriately fund that health care system in order to make sure that we still hold as our core value in delivering care to those who need it most rather than those who can pay the most.”

Dr. Kashif Pirzada, an Emergency Physician in Toronto, tells CityNews that he would start with funding more infrastructure in the health care system if it were up to him.

“Start building more hospitals. I think some are planned, but they’re decades away. Start expanding these facilities [and] anticipate the growth that’s coming, don’t catch up with them. That’s what really gets us in the long run,” said Dr. Pirzada.

Dr. Pirzada works in some of the most under-resourced parts of the city and says right now, COVID-19 is a warning sign.

“We’re doing hallway medicine, and the whole effort right now is to make sure we don’t end up in parking lot medicine, with people flowing out of the hospital. So it’s embarrassing that we have such few resources, and it needs to be fixed.”

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