Published March 7, 2023

Rising complaints on health-care quality: Ontario patient ombudsman

The ombudsman said many problems occur in emergency departments

By Liam Casey in Toronto

Ontario has seen a rising number of complaints about poor quality of care in the health system and an increase in use of force by hospital security, the province's patient ombudsman found in his annual report released Tuesday.

There were more than 3,300 complaints in the 2021-22 year, with most concentrated in the Toronto area and northern Ontario. 

Patient ombudsman Craig Thompson said many complaints focus on access to care and a lack of adequate staffing.

He noted a 43 per cent increase in complaints from patients and caregivers who said they were treated with a lack of sensitivity and caring, especially in emergency departments.

Thompson said the results aren't surprising given the pressures health-care workers are under.

"Everybody's under a lot of stress and I think this report highlights it's on both sides – patients and families are under stress as our health-care providers," Thompson told The Canadian Press in an interview.

"The system is certainly operating under quite a bit of strain, and we're seeing that because the complaints are related to staffing issues and access to care."

His report found that staffing shortages, COVID-19 restrictions and service delays, combined with the fatigue and trauma arising from the pandemic contributed to increased tension and occasionally violence in health-care settings. 

Health Minister Sylvia Jones said patients should be kinder towards health-care workers.

"I think we all have a role to play to make sure that we are being compassionate and we are being patient," Jones said outside the legislature on Tuesday.

Jones said health-care workers have been working "incredibly hard" over the past several years and that she would use the report to see where they can make investments to better patient outcomes.

The ombudsman received 98 complaints about negative experiences with hospital security. 

"Several complainants reported being restrained in an unsafe manner that is inconsistent with the standard training for security guards (for example, with a security guard's knee on their neck or back) that could cause severe injury or death," the report said.

Most of those incidents with security guards occurred in emergency departments, on mental health wards and at screening. 

The ombudsman said many problems occur in emergency departments.

"Hospital emergency departments have become the crucible where many of these pressures on the health-care system ignite," Thompson said in the report.

The ombudsman said his office also received 22 complaints about alleged assaults by security guards.

Thompson said he was concerned about how hospitals responded to complaints as patient-relations representatives often deferred to security. 

The report raised concerns over a lack of a standardized process to investigate incidents involving security and hospital reluctance to share information with patients about who was involved.

The ombudsman also found that complaints about the conduct of security guards was not routinely shared with the Ministry of the Solicitor General, which oversees security guards.

Some hospitals undertook "comprehensive reviews" of security guard incidents, the report said. Several hospitals said they were "actively considering" a requirement for security guards to wear body cameras.

The ombudsman's report comes as the province is in the midst of an ambitious health-care reform plan that aims to alleviate strain on the system. 

Emergency departments across the province temporarily shut down last summer for hours or days at a time, primarily due to a nursing shortage.

There are more than 200,000 surgeries on the backlog list, which includes nearly 12,000 children awaiting procedures.

As part of its reform efforts, the province has tabled legislation that will see more cataract surgeries performed in private clinics. It is also creating a new surgical system for hip and knee replacement procedures to be done in private clinics.

Premier Doug Ford has said patients will not have to pay for the services, but critics have warned of upselling by the private clinics.

NDP Leader Marit Stiles took issue with Jones's plea to patients to be kinder.

"This is clearly victim blaming," she said.

"The fact that this minister would stand here and tell Ontarians that the problem is that they're not being nice enough as patients to health-care workers misses the whole point."

She and other opposition leaders pointed to Bill 124, which caps wages for the broader public sector workers that includes nurses, as a contributing factor to the health-care staffing shortage.

The law was recently found to be unconstitutional by an Ontario judge, although the province is appealing the ruling.

Banner image: THE CANADIAN PRESS/Chris Young

This report by The Canadian Press was first published March 7, 2023.

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