PROVINCIAL ELECTION: Healthcare challenges a key issue in Scarborough races

Sayed’s father has been home for five pain-filled months after a knee operation. He needs another but was told he couldn’t recover in hospital after having both knees done at once.

Sayed’s mother-in-law lives in his dining room, converted to her use along with a downstairs bathroom, at Sayed’s cost, he said, because he learned a provincial home renovation tax credit for seniors could take six months to get.

"Every time we talk about health benefits for seniors it is not actually there," he said Monday near The Scarborough Hospital’s General campus.

Sayed is an enthusiastic supporter of local healthcare: he helped run a community campaign that raised $100,000 for an MRI at TSH Birchmount. Each transaction at his real estate brokerage sends money to the birthing centre at Rouge Valley Health System’s Centenary campus.

Still, he recently waited four hours in Centenary’s emergency room - running now at more than triple its intended capacity - to be seen for severe back pain after a fall. Sayed left, went to Markham-Stouffville Hospital and was treated after less than an hour.

Will such discomfort, or the increasingly-repeated argument that Scarborough residents are being shortchanged on health care, be enough to defeat even one of the six Liberal MPPs running for re-election here?

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• Dec 31, 1969
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Operating rooms at the General campus remain the oldest in the province, while the entire Birchmount is now ranked in the bottom 10 per cent of hospital facilities in terms of physical condition.

Leaders of the two Scarborough hospitals - who told Ontario’s health ministry their three sites all "reached capacity some time ago" - underwent a year of carefully-staged steps toward a merger, only to see it fail in March because the Liberal government refused to give money both hospitals had demanded to cover merger costs and start studying possible new hospital facilities for Scarborough.

The government continued last year to make local health care investments - two new geriatric assessment teams to track and guide high-risk seniors, for instance, along with a nurse practitioner-led clinic on Midland Avenue - but the hospitals remain a sore point.

Not long before the merger, executives of Scarborough’s Chinese Outreach Committee, which has raised health care funds here for two decades, threatened local Liberals with political consequences if their party failed to launch a study that would renew Scarborough’s hospitals.

This week, the group’s founder, May Ye Lee, added she’s heard excuses from MPPs she said form part of a "misleading and inappropriate finger-pointing exercise which leaves no one in power ultimately responsible" for decay in hospital facilities or their lack of operating funds.

But Lee also noted a lack of specifics and commitments from Scarborough candidates of all stripes when it comes to getting Scarborough’s hospitals the capital funding they need.

"I fear that if the Liberals still win (in Scarborough) then their sense of impunity will be limitless," she wrote. "They have proven time and again that it is only the vote they want."

Soo Wong, Liberal incumbent for Scarborough-Agincourt and a former nurse, defended her efforts on behalf of the hospitals last week, saying local MPPs secured an "unprecedented" $3.8 million to study a merger, and promising a "conversation" on the hospitals’ future will continue.

"I have championed this issue and I continue to champion this issue," she said.

There are other health-care related complaints in Scarborough.

Last fall, the province revamped physiotherapy coverage for seniors, which meant residents of Villa Ellegance, an Agincourt condominium where the average age is 86, could no longer use up to 100 free personal sessions a year to manage pain from chronic conditions.

Instead, the seniors can be cleared by a physiotherapist for falls prevention classes twice a week. "They are so unhappy, and their families as well," said May Wong, the building’s manager, adding the change has led to deteriorating physical and mental health in residents which ultimately will cost the system more.

Representatives say staff at local long-term care homes are overworked. A personal support worker there "can have half an hour to get eight patients up, dressed, fed and bathed. It’s just not possible," Kelly Walker, a Canadian Union of Public Employees member said at an Ontario Health Coalition event Monday.

The union and coalition want the province to require nursing homes to hire enough staff to give each patient four hours of care a day.

Though the Liberal government hired 600 full-time staff since 2011 to enhance care "for Ontarians with behaviours like aggression, wandering, physical resistance and agitation," physical attacks in nursing homes are a concern.

On a night in March 2013, one resident of the Wexford Residence was beaten to death and another left injured, while a patient with a record of violent behaviour was charged with second-degree murder.

"It’s rational to think more hands (staff at nursing homes) would eliminate situations like that," said Candace Rennick, CUPE Ontario’s secretary-treasurer, arguing seniors in long-term care "are not having their needs met" because nursing homes are "chronically understaffed and underfunded."

Scarborough’s two Yee Hong Centres for Geriatric Care, however, are so popular it may take seniors applying on a non-urgent basis from home nine years to get in, since the waiting list has grown to 4,500.

In 2011, Yee Hong, which has four nursing homes in total, urged the province to build more long-term care facilities. It’s now starting a different campaign suggesting it could bring "some elements of long-term care" to people in their own homes.

Unlike the Community Care Access Centre, which provides home care on an "episodic" basis, Yee Hong, with its knowledge of cultural requirements, could maintain clients at home over a longer term, Acting CEO Eric Hong said in an interview.

Alex Wilson, New Democratic Party candidate in Scarborough-Agincourt, said TSH’s board was right to cancel the merger, which would have led to service cuts. "Scarborough’s getting next to nothing. That’s why the amalgamation process failed."

But though Wilson said Scarborough’s hospitals are underfunded and understaffed, and that "it’s time for a new hospital" to be built, he conceded the NDP platform doesn’t assure residents this will be done.

Wilson, a minister who once worked as a healthcare aide, said he found people providing home care for agencies "really have to work for a few" to make a living. He proposed dismantling either the area’s CCAC or its Local Health Integration Network and shifting the money saved to the PSWs doing home care.

The NDP is offering voters a caregiver tax credit and pledges to cut emergency room wait times in half, by using two nurse practitioners in every ER.

It’s not clear how NPs could do this at overcrowded Scarborough ERs, which gain financial bonuses if they meet provincial targets - averages of eight hours for patients with complex conditions, or four hours for patients with minor or uncomplicated ones.

Wait times at all three Scarborough ERs have fallen since 2011, with the TSH Birchmount campus as of March at 10.2 hours for complex, 3.5 for minor; TSH General was at 8.6 for complex, four for minor; and RVHS Centenary at 10.9 for complex and four for minor.

Wong said the government has invested millions to bring waits down and almost all patients coming to ERs in Scarborough "are seen within the target time."

New Democrats, she said, failed to support a budget that would have raised salaries for PSWs doing home care - jobs with a high turnover rate - by $4 an hour, though the Liberals still plan for that increase.

"If you respect them, you’d better pay them properly," said Wong, adding Liberals "have strengthened legislated standards" for nursing homes since 2003 and are providing $135 million more to the area CCAC for home care. "I dare say we have increased that significantly."

Raymond Cho, Progressive Conservative candidate in Scarborough-Rouge River, also suggested cutting out bureaucracy - possibly the LHINs - and trimming executive salaries in the system.

A former social worker, Cho said he trusts PC Leader Tim Hudak not to cut front-line health workers, but added he’s not in favour of spending more on health care. "Sometimes we have to swallow very hard pills," and use the resources we have more efficiently, he said.

Asked for his position on Scarborough’s aging hospitals and what should be done with them, Cho said he would simply represent local views to a PC government. "The party has to listen to a guy like me."

Cho did, however, argue the Liberals were wrong to change physiotherapy coverage, because, he said, maintaining seniors’ health and mobility is crucial.

He added the government made "terrible mistake" in requiring practitioners of Chinese traditional medicine to have English and medical certification by creating a self-regulating college practitioners had to join by last month. "They just kill the whole profession," Cho said.