Bed Lam

In the arcane world of Canadian Health Care, understanding the system became even muddier for North Bay and area residents in the past week. Almost everyone knows that there are wait times for many surgeries and we have all heard anecdotal stories about people waiting in emergency rooms for hours. Some of us have even experienced the delays in the system.

Reading a column by Michael Decter on Monday where he reports on a study by Baker and Norton that between 9,000 to 24,000 preventable deaths occur every year in our hospitals might make some who are waiting for surgery consider themselves lucky. Indeed, no one wants to go to a hospital, but circumstances sometimes send us there. Not shown in those startling figures is the number of patients who experience adverse affects of visiting the hospital. Decter goes on the say that it is the quality of care and service that we should be concerned within the hospital system. A large part of the costs in the system are attributable to these deaths and adverse affects that either lengthen the stay in the hospital or lead to litigation on behalf of those whose stay was a little too short.

On top of the medical problems are the financial problems of under-funding and / or administration costs of the hospitals. Running a hospital is not straight-forward business as the customers are very unpredictable in the problems they bring to the door and every so often there is an unexpected rush of customers wanting in for maintenance and repairs. Matching staff expertise with the customer is not always easy and finding beds for everyone can be an administrative nightmare. Sometimes hallways become wards.

The news on Wednesday last that the North Bay and Mattawa hospitals were going to receive some 5.5 million dollars in funding over the next three years was a breath of fresh air for the administrators. The catch was that all the hospitals in Ontario are expected to run without a deficit in the future, something the administrators thought they could do with a reasonable level of funding.

On Thursday North Bay and area residents got the news on how part of this plan was going to affect them. The hospital is going to close 8 surgical beds at the end of the year. The news report said it costs about a $100,000 a year to keep a bed open at the North Bay hospital. One wag suggested that all they had to do was close all the beds and the administration would solve all its financial problems. Assurances were given that there would be no lay-offs of permanent staff (the part-timers would take the hit) and that, along with other efficiencies, the hospital would be able to meet its budget.

Missing in all this was exactly how we are going to get more of the elective surgeries that were promised by the politicians if we have fewer surgical beds. Perhaps we are going to shorten the recovery times of patients, much like the hospitals have done with mothers who now delivery their babies on an out-patient basis. Instead of awakening from the after effects of the anaesthetic sleep in a post-op bed you could find yourself in a wheel chair ready to roll homeward with a set of instructions on how to operate the intravenous drip. The annual cost of a wheelchair has to be a whole lot lower than the $100,000 bed.

Closing beds in the hospitals is probably the right thing to do. But not the surgical beds. One of the biggest issues facing hospital administrators is how to move elderly patients who are waiting for placement in Homes for the Aged. There is a chronic waiting list for beds / rooms in these nursing residences and as the populace ages, this is a growing problem. Perhaps we should be spending our tax dollars on increasing the number of beds in these homes so hospitals could move those elderly people out of the hospital, where they do not need the level of care afforded there, to the homes where they can be looked after in a more suitable environment.

Of course we are only moving the bottleneck from the hospital to the Homes. We might be able to wheel ourselves out of the surgery recovery room but when you become a resident of a Home, you are not allowed to wheel yourself out the door to try to find that house where you used to live, no matter if you can remember where it once was.

While the report that the mortality rate in our hospitals is improving (getting lower) despite the Baker and Norton report, our mortality rate is still 100%. I wonder if there is a long waiting line at the Pearly Gates. Maybe they are closing beds there too.