Thursday, January 20, 2005

Promise - 5,000 long-term beds; reality so far - 100

VICTORIA - The Liberals' promise of "an additional 5,000 new intermediate and long-term care beds by 2006" has faded away.
Almost four years after the election only 100 additional beds have been added to the system. The New Era promise won't be kept, Health Minister Shirley Bond concedes, with the goal now 2008.
It was an important pledge. The new government even created a junior minister responsible for residential care for seniors, and unveiled a big - if hopelessly muddled -strategy in 2002.
The reality is that the province has gone backwards. The 100 new beds falls short of the increased demand created by an aging and growing population.
It's a significant broken promise. The most obvious impact is on seniors who need the care, and their families. They need the kind of care that was promised, and they can't get it.
But it also affects everyone in the province. When long-term care isn't available, seniors end up in the hospital. That is often miserable for them and the people who care about them.
It's also a major reason why people can't get needed surgery and emergency rooms are jammed, with sick and injured people waiting hours, only to end up on stretchers in halls because there's nowhere else for them to go.
Communities across the province have complained about lost long-term care beds. But most have been unable to get good information about the number of beds lost versus any beds added, or the effects.
Here in Victoria the Capital Regional District, reacting to public concern, studied the issue last year. It found that the Vancouver Island Health Authority had closed almost 600 existing residential care beds. It had opened 105 new residential care beds, and 207 assisted living units, which provide a lower level of support.
Do the math, and you find that means there are 205 fewer beds available - about a seven-per-cent decrease in the time the Liberals were promising a major increase. The region is short 325 beds, based on the government's own model.
"The shortfall is a result of closing too many residential care beds too quickly and not having the  alternatives, including  assisted living, in place," the report found. "This was predicted in 2002 and is in large part a function of the provincial government's fiscal restraint." One in three of the people admitted to residential care had been waiting more than 90 days, VIHA reports, and waits have been increasing.
The government and the health authorities have maintained that the need for long-term care was being reduced thanks to increased support to allow people to stay in their homes, or seniors' housing. But that hasn't really happened either, the capital region study found. The number of seniors needing home support services for example, had increased by nine per cent; funding for the service rose two per cent.
Seniors wait months for the care they need. If they are lucky, they're families struggle to cope with their increasingly complex medical care needs. If they aren't, the end up in hospitals, which must cope with over-crowding and delayed surgeries because acute care beds are blocked by people who don't need them, but have nowhere else to go. (The best estimate is that 10 per cent to 20 per cent of acute care beds are occupied by people who shouldn't be there.)
Bond says the government has created 4,300 new spaces, but had to close 4,200 because the facilities were outmoded. But those facilities had served for years; communities pleaded with the health authorities to keep them open until replacement beds were created; and most could have been maintained until the promised 5,000 additional beds were delivered.
Even acknowledging the challenges, the issue has been badly mishandled with no clear plan, inadequate funding and a refusal to listen to the legitimate complaints of seniors and communities and government MLAs.
It's a broken promise that has hurt us all.
Footnote: Former long-term care minister Katherine Whittred had an undistinguished tenure, but she did complain in writing that the ministry was closing beds without having adequate replacements. She never reported on the response. The junior minister's position for long-term care was eliminated a year ago in a cabinet shuffle.

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