The last time the government granted a license to operate a OHIP designated physiotherapy clinic was 1964. This is the alternative government now wants patients to turn to after hospital-based outpatient physiotherapy is eliminated – an almost forgotten system leftover from 50 years ago.
The Designated Physiotherapy Clinics Association (DPCA) gives us a glimpse into the significant number of Ontario hospitals that are reducing access to outpatient physiotherapy services. The DPCA received back 120 surveys of Ontario hospitals in October 2011 and found 50 per cent had reduced outpatient physiotherapy services within the last two years. Further, another 16 per cent indicated that they had planned to do so before the end of that year. This is a significant policy shift with little to no public discussion.
The survey information was part of a DPCA press release this week. Faced with significant cuts to hospital physiotherapy, the DPCA proposes to pick up some of the slack, offering to soldier on at $12.20 per visit for another two years and even help out the CCACs with home care at $60 per visit – half of what they say the present costs are by contract home care agencies.
There are 94 of these designated OHIP clinics in Ontario and distribution reflects the population as it existed in 1964, not 2012. The City of Mississauga, for example, had a population of 156,070 in 1971 (it didn’t become incorporated until 1968). It has no OHIP designated physiotherapy clinics today despite a 2011 census population of more than 700,000 residents. On the other side of Toronto, Oshawa has three such clinics with a population of about 150,000.
Dr. David Walker is accusing long-term care homes of cherry-picking patients who are easy to care for, leaving more complex ones to hospitals.
As the province’s point person on the alternate level of care issue, did he just discover this?
When Ontario decided to put the more than half of its nursing home beds in the hands of profit-seeking companies, what did they expect?
In Dr. David Walker’s summer ALC (alternate level of care) report he gives the example of the Toronto Central LHIN’s efforts to reduce their ALC roster.
Alternate level of care patients are said to be indivdiuals who have completed their acute care but are unable to go home or secure a long term care bed. There used to be an ugly word for them — bed blockers — which appeared to put the blame on the patient for a failure of the system to provide a continuum of care.
The Toronto Central LHIN identified 148 long-stay ALC patients for review. While the LHIN was able to transition 28 of these ALC patients to alternate destinations, 22 were deemed medically unstable and not ALC at all. That’s nearly 15 per cent.
August 31st the Ontario Ministry of Health did a curious thing. They posted on their website a report by Dr. David Walker, who had been appointed ALC lead back in January. There was no press release, no press conference, no op/eds were written supporting Walker’s 32 recommendations. Walker had submitted his report at the end of June, and for two months the government mulled it over before deciding to make it public on the eve of an election. During that election there was virtually no talk of Walker’s report.
ALC is the term for alternate level of care patients — those who have completed their acute care treatment in hospital but are not stable enough to return home.
Normally this kind of treatment of a report indicates a “thanks, but no thanks” attitude by government. However, at a meeting with public service reform commissioner Don Drummond, the Ontario Health Coalition was told that the government has actually accepted the recommendations of Walker.