Acute care

Flu season hasn't officially arrived in Windsor, yet the city's emergency rooms are already bursting at the seams.

Last week Windsor Regional was at 105 per cent capacity. Hotel-Dieu Grace was at 107 per cent. That exceeds the crisis in October, when backlogs meant long waits in the ER and threatened elective surgeries.

The same thing is happening now, and for the same reason. Between the three sites, there are at least 150 patients in acute care beds who shouldn't be there. Frail or elderly, they should be living in long-term care facilities.

One of the reasons they're languishing in our hospitals is a shortage of alternate-care spaces in Windsor, and that problem won't be solved any time soon.

The 256-bed long-term-care facility announced by Schlegel Villages last Friday will take at least 20 months to open. That seems speedy after waiting all those years to get a shovel in the ground at the Hotel-Dieu Grace site, but it's still creating an accommodation crunch.

The other reason is an unfortunate change in provincial policy. Earlier this year Health Minister Deb Matthews struck down the "first bed available" provision that allowed hospitals to transfer ALC patients to any long-term care facility with a vacant room, freeing up emergency rooms for those needing immediate treatment.

While ALC patients could pick and rank their top five choices for long-term care, they were still obliged to take the first available opening under the old rules. It didn't mean they would be forced to stay there indefinitely; they could still move to their desired location when space became available.

In October, frustrated Windsor Regional CEO David Musyj called on the government to reinstate the first bed available policy. "We're turning into a quasi long-term care facility," he said, noting that 91 ALC patients were actually using desperately needed acute-care beds at the time. Because the Liberals had taken away a hospital's ability to charge those patients up to $600 a day, there was no incentive to leave.

It's a touchy subject, because elderly patients claim they're being discriminated against. Nothing could be further from the truth. These are patients who, by virtue of their age and health, meet the criteria for long-term care. With 28 long-term beds empty last week - 18 in Windsor and 10 in Tilbury - hospitals should have been given the right to transfer their ACL patients to them. They would still have had the option of moving into their preferred facility at a later date.

That didn't happen because, as Musyj said, the new policy means "they can stay until they get the one they want."

On Monday, hospital officials were warning of long ER wait times and begging people to stay away unless their conditions were serious. But how do you define that? If you're suffering chest pains or doubled over with kidney stones, the emergency room is exactly where you're supposed to be. If you've got an elective surgery that's been booked for months, you should be able to have it done as scheduled.

The health minister made a serious error in judgment when she put the needs of a small group ahead of the needs of the general population. She has rewritten the criteria in such a way that acute-care patients are being denied life-saving medical attention.

Sadly, this will only get worse unless the Liberals revisit their flawed approach. Our aging population means there will be more and more people needing ALC facilities. Until they're built, those patients must be treated in facilities designed for their needs, wherever they might be located.