Statement from HPCO on the Auditor General’s report

Hospice Palliative Care Ontario welcomes the Auditor General’s report, which includes a section on palliative care in Ontario. The report covers a range of issues, highlighting a need for 755 to 1080 hospice palliative care beds. Right now there are 289 beds and HPCO’s proposal to the government would fund up to 450 beds over the next few years. The report indicates the quality of care being received is good, but the delivery is patchwork and more coordination of care is required.

There was a reference as well to occupancy rates, indicating that they are roughly 80%. Occupancy rates are not an adequate measure of bed usage. Occupancy rates vary based on several factors including delays in assessment for admission, timing of referrals, acuity, how long individuals are in hospice before they die, and the readiness of individuals to go to a hospice.

Residential hospices are in fact now caring for a greater number of people each year, but the average length of stay has decreased from 21 days to 18 days, in part due to improved home care supporting more people receiving care at home before needing residential hospice.

The aging population is inevitably and rapidly escalating the numbers of people needing hospice palliative care. We know from experience here in Ontario and around the world that hospice palliative care is desirable, providing comfort at the end of life for patients and their families, and it is cost effective.

The Auditor General’s report notes that hospital beds are more than double the cost of a residential hospice bed. Additionally, we know that there are 12,000 people a year in Ontario who die in hospital, needlessly, simple because they can’t stay at home and there is nowhere else for them to go. Palliative care is provided in a continuum of settings from the home, residential hospice, long-term care, to hospitals and quality hospice palliative care is needed in each.

The hospice palliative care sector has been working in goodwill and in good faith with its partners in the health care sector, and with the government for nearly a decade now, with great results. We are ready to grow capacity to provide care. We know it has to happen now. And we will continue to work with the government to develop and implement a plan to expand access to care throughout the province.