Underwhelmed – First initiatives around seniors strategy more politics than transformation

Yesterday Health Minister Deb Matthews announced the first specific initiatives following the release of Dr. Samir Sinha’s summary of recommendations for Ontario’s Senior Strategy.

You may have missed the headlines largely because it mostly attracted a big shrug, aside from our colleagues at SEIU. They issued a news release to praise the offer of additional training for 200 personal support workers (PSWs) to help these workers provide support for seniors with dementia and challenging behaviors. There is no denying it is at least a step in the right direction. Nobody knows exactly how many PSWs there are in the province – estimates range from a low of 60,000 to a high of 100,000. There are said to be 26,000 PSWs working just in the home care sector. When we saw the offer to train 200, our first reaction was to wonder whether some zeros were missing?

The Minister did also make a less specific commitment to improve resident safety, quality of care and abuse prevention through new staff training and development. Let’s hope it’s on a much larger scale than their plan for PSWs.

The announcement also called for a 50 per cent expansion of the number of short-stay beds in long-term care to help transition seniors from hospital. While that may sound very impressive, the actual numbers amount to just 250 more beds, and we’re still waiting to find out whether these are new licensed beds or merely being carved out of the existing stock of about 76,000 long-term care beds in Ontario. Dr. Sinha had suggested to the Toronto Star that the number of nursing home beds needs to triple over the next 20 years. That means Deb Matthews needs to announce something more on the scale of 7,600 new beds per year to make that happen.

Earlier this week we reported Thunder Bay was in a bed crisis and was looking for alternate care for 86 ALC patients. That’s just one hospital out of more than 150 that may be looking for these 250 beds.

Oddly, while the acuity and complexity of patients in long-term care is on the rise, Matthews is only announcing more supplies and equipment. We hope that there will be a subsequent announcement about more clinical professionals to go along with the equipment and supplies. It’s great to see PSWs finally get their due, but many residents face significant health challenges and need an appropriate staffing mix.

What’s more alarming is that these kinds of announcements are meant to substantiate the idea that services are not being cut, but are being instead transferred to community-based providers.

Yet every day we are seeing hospitals announce new cuts . We are still in “year one” of zero-base budgeting for hospitals. What will the cumulative effect be by year five of the government’s austerity plan?

Bluewater Health in Sarnia is just the latest to announce that hospital staff cuts are coming. The media reports changes to the funding formula means Bluewater has to find another $5 million before the end of this fiscal year (March 31). One nurse told the Sarnia Observer that the current ratio on the cardiac unit is one nurse to three patients. That could jump to a 5-1 ratio if a plan to merge the intensive care and cardiac units takes place to save money.

Bluewater’s cardiac unit was newly created as part of a $319 million hospital expansion in 2010. We can’t help but note that there is an astonishing frequency in these stories between staff cuts at hospitals and large building expansion/replacement projects.

Are 250 beds spread out across the province going to be sufficient to maintain quality care ratios in the cardiac unit of Bluewater Health? Of course not.

Is training 200 out of tens of thousands of PSW going to improve the quality of care across Ontario’s more than 600 nursing homes? Not likely, unless each PSW plans to share their training with at least two more homes each.

Are we going to see more hospital cuts while the province maintains services are merely shifting? Absolutely.

While Matthews deserves credit for getting something going, there also seems to be a step missing in this process. Last week we got a look at a 21-page summary of Sinha’s report – the full report is not yet public. While Matthews ties these initiatives to Sinha, we have no idea yet of how much or how little she intends to implement. Shouldn’t the public at least have time to view the complete report and respond before the government adopts it in part or in whole?

One response to “Underwhelmed – First initiatives around seniors strategy more politics than transformation

  1. Training 200 PSW’s is definitely not enough however, they could be trained in a way so that they can further train more PSW’s. They can be the mentors or a “go to person” in a facility where they work.

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