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Charter Challenge Against Ontario’s Bill 7 Unfolds in Court

A significant legal challenge is set to begin on Monday, scrutinizing the constitutionality of a contentious piece of legislation in Ontario that enables hospitals to assign discharged patients to long-term care facilities, even against their wishes. Failure to comply can result in a hefty fee of $400 per day.

The Advocacy Centre for the Elderly, alongside the Ontario Health Coalition, contends that this law, formally known as the More Bed Better Care Act or Bill 7, breaches the Charter of Rights and Freedoms. However, the provincial government maintains a contrasting viewpoint.

One of the pivotal issues the court will examine is whether the legislation has achieved its aim of enhancing patient flow within the healthcare system. Legal documents indicate that both parties have drawn different conclusions based on the available evidence.

Premier Doug Ford’s administration fast-tracked Bill 7 through the legislature in September 2022, circumventing public consultations, which has led to dissatisfaction among various stakeholders.

Details of Bill 7’s Implementation

This law empowers hospital placement coordinators to unilaterally assign patients, designated as requiring an “alternate level of care” (ALC) by a physician, to a nursing home without obtaining their consent. Furthermore, patient health information can be shared with these facilities without prior approval. Additionally, patients may be placed in nursing homes located as far as 70 kilometers from their chosen destination in southern Ontario and up to 150 kilometers away in the northern part of the province, a stipulation that has generated outrage among the elderly community.

In filings presented to the court, the organizations challenging Bill 7 argue that it has failed to reduce the number of ALC patients. They reference Ontario Health data indicating a 30 percent increase in this patient category over a year after the law went into effect. As of January, approximately 2,300 discharged patients were still waiting in hospitals for placement in a nursing facility.

Claims of Ineffectiveness

Opposition groups assert that the evidence challenges any assertion that Bill 7 has expedited transitions from hospital care for most ALC patients. They highlight that the primary reason for delays is not attributable to patients but rather to a critical shortage of long-term care beds, underscored by lengthy waiting lists for homes that provide appropriate care.

The groups advocate for the law’s repeal on the grounds of its ineffectiveness and arbitrariness. In contrast, provincial representatives argue that the surge in ALC patients can be attributed to broader demographic growth and assert that various hospital administrators support the legislation, claiming it has facilitated patient movement.

For instance, Trillium Health Partners, which operates two major hospitals in Mississauga, reported facilitating the transfer of 240 ALC patients to nursing homes within a three-month period. The organization’s chief operating officer, Scott Jarrett, stated in an affidavit that without Bill 7, patient flow would be hindered, leading to a greater number of patients occupying acute care beds unnecessarily.

The Advocacy Centre and the Ontario Health Coalition maintain that the law disproportionately impacts seniors, particularly those struggling with mental and physical health issues, thus stripping them of their rights to choose where to live and how their health information is managed.

Focus on Patients’ Rights

Over 80 percent of ALC patients are aged 65 and older, many of whom contend with chronic-age-related conditions. Opponents of Bill 7 argue that it infringes upon patients’ fundamental rights to liberty and security. They contend that it undermines personal autonomy concerning medical treatment and health care decisions.

The provincial government, however, argues that patients do not possess a Charter right to remain in a hospital free of charge after discharge and denies that the law discriminates based on age or disability. Additionally, they assert that patients are not forced into a specific nursing home, as they retain the right to refuse placement, albeit at the risk of incurring the aforementioned daily charges.

The organizations challenging the law characterize this charge as coercive, while the province argues it serves as a deterrent to encourage voluntary transitions to undesired homes.

Despite the threat of financial penalties, stories like that of Ruth Poupard’s family illustrate the issue’s complexity. Her daughter, Michele Campeau, stood firm against hospital pressure to place her mother in a nursing home she deemed unsuitable. After being charged $400 per day, the family eventually sought placement in a more appropriate facility, ultimately avoiding the penalized payment.

As the court proceedings commence, the central focus remains on whether Bill 7 effectively addresses Ontario’s ongoing challenges in managing healthcare resources, particularly the availability of hospital and long-term care beds.

Source
globalnews.ca