Social Policy in Ontario

On the last afternoon of 1959, I drove to Orillia with a friend of mine and his 12-year-old son. The boy is handsome, with large, dark eyes, but he is not very communicative for he will always have the mind of a child. He is retarded mentally. On holidays he comes home to his parents. The rest of the time he is a patient at the Ontario Hospital school.

There are 2,807 others like him, jammed together in facilities which would be heavily taxed if 1,000 patients were removed. More than 900 of them are hived in 70-year-old buildings. There is nowhere else for them to go.

It is distressing to visit these older buildings, as I did last week. The thought of fire makes the hair rise on your neck. The stairways have been fireproofed; nothing else. The paint peels in great curling patches from the wooden ceilings and doors. Gaping holes in the worn plaster walls show the lath behind. The roofs leak. The floors are pitted with holes and patched with ply. The planks have spread and split, leaving gaps and crevices that cannot be filled.

The beds are crammed together, head to head, sometimes less than a foot apart. I counted 90 in a room designed for 70. There are beds on the veranda. There are beds in classrooms. There are beds in the occupational therapy rooms and in the playrooms that can no longer be used for play. On some floors the patients have nowhere to go except out into the corridors.

The stench here is appalling, even in winter. Many patients are so helpless they cannot be toilet trained. The floors are scrubbed as often as three times a day by an overworked staff but, since they are wooden and absorbent, no amount of cleansing will remove the odors of 70 years.

On one floor there is one wash basin to serve 64 persons. On another floor, where the patients sometimes must be bathed twice or three times a day, there is one bathtub for 144 persons — together with three shower outlets and eight toilets. Prisoners in reformatories have better facilities.

Designed for the wrong patients

The newer “cottages,” as they are euphemistically called, are often excellently designed, clean and fireproof — but they, too, are overtaxed and often misused. Buildings built in 1932 for 144 patients now house 220. And because they have been fireproofed, they now have the wrong patients in them. They were designed to serve high-grade patients — those with an I.Q. of 50 or more. But, because of the threat of fire, the more helpless inmates have had to be placed in them. Those of higher intelligence have been switched to the non-fireproof buildings because they are better able to escape on their own.

The authorities face a serious dilemma at Orillia. In order to fireproof the old buildings they would have to evacuate all the patients. But there is nowhere to move them. They could, of course, erect new buildings, then tear the old ones down. But the waiting list for the hospital school is so large nobody really believes they could be torn down — even if others were built. There are just too many people knocking on the door.

There are 4,000 names on the file at Orillia — names of people who have applied to enter a retarded child in the institution. The active waiting list — of people who have written within the last year — is 1,500. Even the new hospital school being completed at Cedar Springs cannot accommodate this number.

In 1949, Orillia admitted 196 new patients. In 1959, the number had grown to 310. At the present time they are coming in at the rate of three a day. The hospital loses, by death or discharge, less than half the number it admits annually. And so the terrifying problem builds up year by year.

There are several reasons for this. One, obviously, is the population increase: for every 200 children born this year in Ontario, three will need institutional care. Ironically, too, medical advances have almost doubled the lives of many mentally retarded patients. The big move to the cities has made it difficult to care for a retarded child at home, and the “village idiot” of our forefather’s day is likely to be a patient at Orillia now. Finally, because of a change in public attitudes, people seek out institutions which they once shunned.

A patient suffocates to death

Orillia is overcrowded and understaffed. These two evils recently produced a chain reaction that caused a patient’s death. Three years ago there was a bad fire in the basement of one of the older buildings. The danger was so great that a supervising nurse from the neighboring infirmary was called to help evacuate the inmates. All were saved but, in the nurse’s absence, an infirmary patient released a cloud of steam which caused one woman to suffocate.

Political considerations have made Orillia’s situation more acute. The hospital was originally designed for children of six years and older. It is now heavily overcrowded with children under that age. Medical authorities are convinced that many of these would be better off at home during the early years. But many have by-passed the waiting list and the regulations because of pressure from Ontario MPP’s.

Construction and renovation at Orillia comes under the Department of Public Works, long the focus for political patronage in Ontario. Until recently, the department has had little liaison with the Department of Health which operates the hospital schools. Instead of rebuilding from the ground up, to careful plans, it prefers to work in a piecemeal manner — patching and renovating. Often the pace seems maddeningly slow. The remodelling of the administration building at the hospital began last April. It’s still not complete. By contrast, a private contractor completed the floor-to-ceiling remodelling of the Orillia YMCA, a $250,000 job, in just four months.

But Orillia’s real problem is one of public neglect. It is easier to appropriate funds for spectacular public projects such as highways and airports than for living space for tiny tots with clouded minds. Do not blame the present Department of Health for Orillia’s condition. Blame yourself.

Remember this: After Hitler fell, and the horrors of the slave camps were exposed, many Germans excused themselves because they said they did not know what went on behind those walls; no one had told them. Well, you have been told about Orillia. It is, of course, no Belsen. In many respects it is an up-to-date institution with a dedicated staff fighting an uphill battle against despairing conditions. But should fire break out in one of those ancient buildings and dozens of small bodies be found next morning in the ashes, do not say that you did not know what it was like behind those plaster walls, or underneath those peeling wooden ceilings.

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