What springs to mind when we think about the ‘future’ of healthcare in Canada? Maybe it’s space-age hospital facilities with lots of automated technologies? Maybe it’s microsurgery and advanced, minimally-invasive treatments?
Perhaps more realistically, could it be a move away from inpatient treatments towards a more community-focused model of medical care? There are many who think so – but is it really realistic to think that our future will be one with fewer hospital beds, instead of more?
An article written by leading cardiologist Dr Stephen L Archer, who leads the department of medicine at Queen’s University and co-leads the medicine program at Kingston Health Sciences Centre, suggests that it isn’t – and that our healthcare system urgently needs more beds, not less.
In an article for the Kingstonist earlier this year, Dr Archer addressed the fact that Toronto’s hospitals had to transfer thousands of Covid-19 patients to other facilities across the Province – some of them involuntarily – due to a lack of available beds. He said the bed shortage could not be solely attributed to the pandemic, but to wider bed shortages that were highlighted by the crisis.
He writes: “In reality, as medicine becomes more high-tech, admissions are shorter but more beds are needed to support procedures that improve the quality and duration of life. We are now putting heart valves, hips, lenses and more into older Canadians, and performing lifesaving diagnostic and therapeutic interventions on people who 20 years ago would have been considered ineligible because they were too premature, too obese or too high-risk. Canada’s bed shortage is particularly critical in academic health sciences centres that uniquely deliver advanced forms of care. Pre-pandemic Ontario was running at 96 per cent occupancy.”
Dr Archer rightly points out that short-term fixes like hallway medicine and ER waiting time targets don’t address the root causes of bed shortages. As well as insufficient hospital beds, these include insufficient care home or long-term care beds for patients who require step-down care.
Time for change
In order to create the additional capacity needed to cope with Covid-19, hospitals across Canada cancelled ‘elective’ admissions for patients requiring joint replacements, cancer therapy and many other procedures that are not really elective at all. It’s clear that something has to change.
We’ve already seen major funding released for the long-term care sector that will dramatically increase the number of beds available in this sector over the next decade and beyond – and indeed, Belroc is already engaging with some of the stakeholders who will be responsible for delivering this new infrastructure.
Hospital beds may require a more complex strategy that could see the ‘where and how’ of the way care is delivered being changed dramatically.
Cancer patients, for example, have been hard hit by the pandemic. We’ll never know for sure how many lives have been lost because of delays and cancellations in life-prolonging care. In future, it’s vital that people with cancer and other serious health problems don’t become indirect victims of more widespread health crises, whether that’s an acute problem like another pandemic, or a chronic issue like bed shortages. As a result, we may see the advent of specialist care centres where things like cancer treatments and orthopaedic surgeries can continue, unaffected by the acute challenges faced in general hospitals.
Whatever happens, as we move forward from the events of the past 18 months – and the decades of underinvestment that preceded them – we now stand on the cusp of an exciting and formative moment in the history of Canada’s public healthcare system. The decisions made and the facilities constructed in the next ten years will impact our nation for generations to come.
At Belroc, we’re watching these developments with great interest while keeping our finger on the pulse of innovation in our own sector, so that we’re ready to bring the best advice and expertise to the table for our clients and for service users. We look forward to playing our part!