Increasing the number of beds in the healthcare system in Ontario alone will not solve the problem of overcrowding in hospitals, according to a report that will shape Prime Minister Doug Ford's reforms.
The report, officially released on Thursday, comes from the chair of the Health Care Improvement Council and Ending Hallway Medicine, a select panel of 11 executives led by close ally of Ford.
The council is mandated to provide advice to Ford and Christine Elliott, Minister of Health Ontario, on shortening hospital waiting times, terminating so-called "Feeding Medicine" and making long-term structural changes to the system.
The report, which was released Thursday morning, also states that too many patients come to hospital emergency rooms under conditions that could be treated elsewhere.
While this report states that the province "does not have enough hospital or long-term beds to meet the health needs of the population", it does not expect an increase in the number of beds.
"The simple addition of additional hospital or long-term beds into the system will not solve the problem of health care in the Ontario corridor," says a 32-page document.
It says that hospitals do not use existing beds as efficiently as possible and as a key factor describes "insufficient capacity" in home care and community mental health.
"There are people in the entire province who spend time in hospital beds because they have no access to other health care options," the report said.
"Going to a health care emergency service that could be provided somewhere else is often done in Ontario, sometimes because it is the only medical facility that is open 24 hours a day."
While the Council explains what it considers to be the cause of the overcrowding of the hospital, it has yet to issue specific recommendations for change. They will come in their next report to be in the spring.
It's a sure bet that the Ford government will have advice. The council is led by Dr. Rueben Devlin, longtime managing director of Humber River Hospital, former president of the Progressive Conservative Party of Ontario, and Ford's confidant. He was appointed to the post on the day the Ford government took over the government in June.
"It provides some very useful insights," Elliott said at a press conference on Wednesday.
The report states that the lack of community-based mental health services is partly blamed for tensions in hospitals
"The council is concerned that patients do not have access to mental health services and addictions if they are most needed," she writes.
"Long waiting times for community treatment mean that sometimes the conditions of patients get worse when they're sitting in a queue, and they give them no choice but to seek care through the emergency department."
Devlin has already publicly provided strong indications of where his recommendations for reform are directed.
"We know there are problems with the healthcare system, but how do we fix it?" Devlin said in the closing speech of an audience at Algonquin College. "People say," You can not improve the system and improve the quality and still save money. " It is not true."
The biggest immediate challenge faced by the Devlin Group – and the Ford government – is the overcrowding of hospitals.
Occupancy rate is unsustainable, Devlin said in November. He pointed to the Ministry of Health's projections on hospital capacity, indicating that the province needs another 8,000 hospital beds by 2028, but only 1,700 patients are planned.
"Will we build 6,300 beds of patients with their associated capital costs and operating costs or will we provide another kind of healthcare?" Devlin asked.
"Do we have to look at where patients can heal. If we deal with some of the treatment problems in the corridor, how do we get to patients to get into primary care rather than appearing in the emergency department?"
Devlin also asks whether it would be wise to provide 41,000 additional long-term care facilities that are needed for the needs of the Department of Health.
"Will we really institutionalize our elderly people?" Devlin said in November, characterizing long-term care homes as the last resort. "We want to provide care for people in the community, at home and wherever they can get out of institutions."
Devlin wants to redesign services to focus on patients and families
"We are getting a lot of feedback that the navigation in the system is difficult," he said. "If we have to get a family member into long-term care, it's difficult. If I have to take my loved one through cancer care, it's hard."
Devlin has an idea of what Team Ontario says about the health system. "No matter where you are, we'll take care of you, the one you want to call, one web site, someone who is going to navigate the system and make it better for you, in my opinion that's where we should be today. "
The use of technology to improve the system is another key issue in Devlin's approach. It represents a hospital unit that is able to get the entire hospital the whole healing history by pushing its Ontario Health Insurance Plan (OHIP) card.
It shows the Provincial Digital Military Headquarters and highlights the possibilities of virtual care, such as checking the patient to investigate his blood pressure at home, and the result is transmitted online to his doctor.
Some healthcare organizations (HMOs) in the US provide practically more than half of the care, Devlin told the audience of Algonquin College.
Devlin wants "the Department of Health and an organizational structure that is skillful and effective." He said it would require "a little organizational change."
He made a statement before CBC News announced that, according to many sources, the government plans to dissolve the local health integration network (LHIN).
He said he showed his challenge to this team: "What will be the future of health care? How will we provide health care for 20 and 30 years?"
At a press conference Wednesday, Ford said his government is focusing on hearing from doctors, nurses and other healthcare workers.
"We are asking for their ideas and our task is to review these ideas and then to implement these ideas," Ford said during the announcement at the Center for Addiction and Mental Health in Toronto.
"Nothing is worse than a lot of politicians who tell the people at the front whether it's education, whether it's health care, how to do their job when they do it every day."