What ‘hallway health care’ looks like in Ontario’s most crowded hospital system

During the election campaign, the Tories said they’d put an end to hallway medicine — but in London, where patient advocates say the problem is worst, that may not be easy
By Mariam Mishriki - Published on June 20, 2018
a gurney in a hospital hallway
In London's main hospital network, medical staff treat patients in corridors, storage areas and other "unconventional spaces" when beds aren't available. (iStock.com)

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LONDON — On a summer night three years ago, Alex Godfrey was admitted to the emergency room at Victoria Hospital in a manic state. What was supposed to have been a one-night stay while staff found her a bed in the mental-health ward turned into four nights and five days in the emergency department.

Godfrey was kept in a small room with no windows to the outside. She says she had nowhere to roam and nothing to do while she waited to be admitted to the mental-health floor.

“I felt a lot like this little caged zoo animal,” said Godfrey, who was 20 years old at the time and preparing to continue studying accounting and psychology at Western University. “It definitely hindered my healing,” she said. Godfrey didn’t return to school.

Hospital overcrowding emerged as a major issue during the recent provincial election. The Progressive Conservatives campaigned on a promise to end so-called “hallway health care,” vowing to add 15,000 long-term care beds over five years and 30,000 beds over the next decade. The PC platform also included a promise to spend an additional $3.8 billion on mental health, addictions, and housing. (A party spokesman said the new spending would be spread over 10 years and the cost would be split with the federal government; he did not elaborate on how the federal portion of the funding could be guaranteed.)

A local public-health-care advocacy group says London is ground zero for the problem of patient overcrowding in Ontario hospitals. Victoria Hospital is one of a number of facilities that belong to the London Health Sciences Centre; Peter Bergmanis, spokesperson for the London Health Coalition, said it’s the most overcrowded hospital system in Canada.

“What’s happened to hospitals in London is a crisis of a magnitude we’ve never seen before,” Bergmanis said. “We’ve been faced with an austerity program that has reduced funding to a point where we [have] the least-funded hospital system in the entire country.”  

Bergmanis said data collected in November and December of last year shows patient admissions at London hospitals ranging from 105 per cent to 165 per cent of capacity at normal times. At peak times, the patient load reaches 177 per cent. To put that into perspective, if a 1,000-bed facility is at 177 per cent of capacity, that means 770 people are waiting for a bed.

“That [would be] people waiting in corridors, in vacant rooms, and in storage closets, just to be able to be admitted into a bed,” Bergmanis said.

To raise awareness of the issue, the London Health Coalition organized a gruesome rally at Victoria Hospital last month, wheeling plastic skeletons on hospital beds outside the facility to make their point.

Peggy Sattler, who was re-elected as the NDP MPP for London West on June 7, said hallway medicine has become normalized in Ontario. In overcrowded facilities, make-do places such as hallways and storage areas have been turned into hospital rooms. She says mental-health patients are lined up in hallways and on stretchers for days at a time. “The lights are on 24 hours. They have no privacy. No dignity. No access to a call button to get a nurse. No access to a washroom,” said Sattler, who spoke with TVO.org during the election campaign.

During her stay at Victoria Hospital in 2015, Godfrey remembers communicating her anguish to hospital staff by writing down how she felt and putting the notes on the little window in the door of her room. “They would just come and peek in the window and check in on me, or shoot me up with some drugs,” she said, “without actually giving me anything to do to pass any time.”

LHSC would not speak directly to Godfrey’s experience, but a spokesperson said patients in unconventional spaces receive the same quality of care as those patients being cared for in traditional hospital beds and rooms.

Sherri Lawson, interim vice-president of mental-health and emergency services, acknowledged that the hospital network has long experienced significant occupancy pressures. “I want to acknowledge the hardship this situation causes for the patients and families impacted and apologize for any inconvenience and stress that has resulted,” Lawson said in a statement to TVO.org. “Having a formalized process in place to leverage unconventional spaces as a short-term measure allows us to ensure the provision of safe, quality care during periods of full capacity.”

Sattler blamed the problem on the previous Liberal government. In the case of LHSC, she said, a five-year hospital funding freeze left the organization’s budget $141 million lower than it would have been otherwise. (LHSC’s annual operating budget was $1.2 billion in 2016-17.) The hospital network made up the difference through staff attrition, Sattler said. “That means when there are retirements or vacancies opened up, they’re just not replaced. Those staff are being lost.”

(The outgoing Liberal government’s budget, unveiled in March, included an $822 million increase to hospital funding for the current fiscal year and a promise to spend an additional $2.1 billion over the next four years on mental health.)

Eric Weniger, who was then the PC candidate in the riding of London–Fanshawe (he lost to New Democrat Teresa Armstrong), said during the campaign that nurses and doctors do not get to use a big enough share of the funding allocated to hospitals. He said a PC government would listen to medical staff and make sure that front-line health-care funding goes where the care actually happens. “We’re looking to get rid of care in hallways as soon as possible,” Weniger said.

Bergmanis said London needs an immediate moratorium on any further cuts to its hospital system.

“We have an aging population, we have a growing population, we need more beds,” he said. “We need to rebuild hospital capacity.”

Mariam Mishriki is based in London, where she’s pursuing a master’s degree in journalism and communications at Western University.

This is one in a series of stories about issues affecting southwestern Ontario. It's brought to you with the assistance of faculty and students from Western University’s Faculty of Information and Media Studies.

Ontario Hubs are made possible by the Barry and Laurie Green Family Charitable Trust & Goldie Feldman.

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