Advocates urge Ontario human rights chief to probe ‘discrimination’ denying hospital care to long-term-care residents
Posted: March 17, 2021
(March 16, 2021)
By: Michele Henry, Toronto Star
Seniors advocates across Ontario are calling on the province’s human rights watchdog to probe “systemic discrimination” at the heart of a health-care system that has, during COVID, quietly and “coercively” denied hospital care to the elderly.
The Advocacy Centre for the Elderly, Ontario Health Coalition and Ontario Coalition for Hospital Unions have joined forces to appeal to Ena Chadha, Ontario’s human rights commissioner. They want her to use her powers of inquiry to investigate the decades-old policies that have not only led to this discrimination, but have also made it so that only a fraction of the long-term-care residents with the virus get lifesaving care.
“How fair is that?” asked Michael Hurley, president of the Ontario Council of Hospital Unions of CUPE. “You spend your whole life working, paying taxes, helping to build the country and then you get COVID and there is no bed for you. There is a policy in effect to deny you care.”
As of late February, just 13 per cent of LTC residents who had died of COVID were transferred to a hospital, the letter said. A recent Star investigation that analyzed COVID deaths from March to December 2020 found that nearly 80 per cent of those aged 80 to 89, who were still living in the community at large, were first hospitalized before succumbing to the virus. By comparison, the Star found, just 24 per cent of long-term-care residents had been sent to the hospital before they died.
The 39-page letter, sent to Ontario Human Rights Commission on Tuesday, is a long time in coming. Collectively and separately, the advocacy organizations have spent more than two decades working to resolve these issues and to make the case that poor health care for the elderly is not just a one-off problem.
“It’s a systemic issue that has just gotten worse and worse,” said Jane Meadus, lawyer at the Advocacy Centre, a legal clinic that provides specialty service to low-income seniors. “COVID has magnified.”
While COVID continues to shine a light on the inequities in Ontario’s health-care system, Meadus said problems that underlie the current crisis have been festering for a long time. At this point, she said, the advocate groups want an acknowledgment that what is facing older Ontarians is bigger than COVID and even the conditions within hospitals and each long-term-care facility.
Ontario’s Human Rights Commission has the capacity to determine whether cuts as far back as the 1990s have conspired to create a health-care system that harms the elderly disproportionately. Currently, the commission is similarly probing whether discriminatory policing practices have overwhelmingly hurt Black Ontarians. It’s also probing whether Ontario schoolchildren who have trouble reading are getting the literacy resources they need and deserve.
The problems with health care for the elderly today, the letter said, began in the1990s when the province cut 14,815 acute care and 6,109 complex beds, slashing the system’s ability to care for rising numbers of chronically ill patients. Even though beds have been added over the years and then taken away again, the province’s population has risen by millions and demands have far outpaced available resources.
This “most extreme hospital downsizing policy in the developed world,” the letter said, gave rise to what Hurley calls a “smear” against the seniors, leading to the perception that older, chronically ill patients are “bed blockers” taking up space needed to treat younger patients. To cope with that, the letter said, hospitals developed strategies to get seniors out of the hospital quickly.
That has included reducing the length of stays for ever more critically ill patients and using long- term-care facilities to deal with medical issues beyond their ability.
Since the pandemic began, more than 4,000 of Ontario’s roughly 7,000 COVID deaths — about 55 per cent — were among elderly residents in long-term care. During COVID, this “dehospitalization” has been intended to “choke off the right of these long-term-care residents” to go to hospital, Hurley said.
“Provincial policies have created a culture of “hospital avoidance,” the letter said, leaving the elderly with “minimal care” while they were dying.”
Today, the letter said, Ontario has about 2.2 hospital beds per every 1,000 residents, which is the fewest in Canada and lower than almost every other developed country aside from Chile and Mexico. And wait lists for a bed in long-term-care can stretch into the tens of thousands.
The scarcity of beds has led to concerns, the letter said, that families are being lied to — and “coerced” — into keeping their loved ones out of the hospital and in homes that aren’t equipped to care for them. Lawyers at the Advocacy Centre said they had received “numerous” calls from families who said they had to “compel” long-term-care homes to call an ambulance, the letter said. And that was after the homes cited hospital policies “sometimes incorrectly,” the letter said, to dissuade them. According to the letter, that flies in the face of the family and patients’ rights.
“The elderly have been treated as second-class citizens,” Meadus said. “In our experience the pressure on patients and their families to accept inappropriate discharges has been extreme and is not only unacceptable and often illegal.”