Ontario ombudsman could hold hospitals to account

TheStar.com – opinion/editorialopinion
Published On Sun Apr 08 2012.    André Marin

A series of stories in Thursday’s Star painted a sobering picture of how hospitals in the Greater Toronto Area compare to those in the rest of Canada. Data from the Canadian Institute for Health Information (CIHI), released via a great new online tool, indicate problems in 11 of 18 local hospitals compared to hundreds of acute-care facilities across Canada.

Sadly, these problems are not the only examples of how the GTA — and Ontario — lag behind the rest of the country when it comes to hospitals.

Ontario is also the only province whose ombudsman cannot investigate hospitals and long-term care facilities.

What’s the connection? Well, I’m not saying that the lack of ombudsman oversight means Ontario hospitals don’t perform as well as they should. But I am confident that they would perform better if they were subject to the scrutiny of my office, like virtually every other provincial ministry, agency, board, tribunal and Crown corporation.

Many of the problems identified in the CIHI survey — less-than-adequate nursing care, mortality rates, administration costs — are issues that Ontarians have brought to my office in the past. Every year, we hear from hundreds of patients and their loved ones who say they’ve endured inadequate care, unsafe conditions, even neglect and abuse in hospitals.

In the fiscal year just ended, we received some 375 complaints about Ontario hospitals that we were forced to turn away. I can only imagine how many we would receive if we were actually able to act on those complaints.

The Quebec ombudsman, for example, recently reported on several cases where her staff helped people struggling with poor care and maladministration in hospitals. A woman caring for her dying husband who was barred from hospital because of infection controls. A man whose wife died after childbirth because of inadequate aftercare. A woman with Alzheimer’s who was stranded alone in an emergency room because hospital staff would not let her daughter accompany her.

In each case, the ombudsman recommended policy solutions to prevent others from suffering the same treatment. My ombudsman colleagues in other provinces have similar stories. It’s tough to explain to them why we in Ontario are barred from helping people this way. The very first Ontario ombudsman, Arthur Maloney, asked that same question in 1979. I remain hopeful, but so far nothing has changed.

I’m often asked — especially now that budgets are so tight — how much it would cost to extend the Ontario ombudsman’s mandate to include hospitals. The naysayers envision a huge, expensive new layer of bureaucracy. But there’s no reason it can’t be cost-neutral. Indeed, that was the experience in Quebec — resources were simply reallocated from the health ministry.

And it’s worth noting that my office is already extremely cost-effective. In the past fiscal year, we handled about 18,000 complaints on a budget of about $11 million.

Speaking of money, the powers of the provincial auditor general were recently expanded to cover hospitals. This is often cited as adequate oversight. But we all know the impact of hospitals on people’s lives goes far beyond financial matters.

An ombudsman looks for administrative efficiencies in human terms — by cutting through red tape and rigid rules, by recommending ways to streamline processes and improve public service and governance. My office has helped countless Ontario agencies do this. We could do the same for hospitals.

The CIHI data and the Star’s reporting on it are an excellent illustration of how greater transparency can benefit the public. Making this kind of information available about hospitals allows patients across Canada to become better informed and engaged, and will contribute to better services all round.

Why, then, shouldn’t Ontarians with complaints about those hospitals be able to access the same independent, impartial complaint mechanism as other Canadians — their ombudsman?

André Marin is the ombudsman of Ontario

< http://www.thestar.com/opinion/editorialopinion/article/1157665–ontario-ombudsman-could-hold-hospitals-to-account >

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