Metric not included in latest Ontario Health annual report, with one emergency physician calling it \u2018utter malpractice\u2019 to not release the data publicly<\/p>\n
Editor’s note: This article originally appeared on The Trillium<\/a>, a Village Media website devoted exclusively to covering provincial politics at Queen\u2019s Park.<\/p>\n An average of 1,390 Ontario patients were treated each day in \u201cunconventional spaces\u201d \u2014 mainly stretchers in emergency department hallways \u2014 in early 2024, according to Ontario Health\u2019s 2023-24 annual report.<\/p>\n This was slightly higher than the average of 1,326 patients the year prior, the agency stated in its 2022-23 annual report.<\/p>\n This figure, however, was not included in the agency\u2019s latest annual report released last month, although several emergency doctors who spoke with The Trillium say hallway health care is a problem that physicians, nurses and patients continue to face on a regular basis.<\/p>\n In fact, the 2024-25 annual report from Ontario Health, the agency overseeing the province\u2019s health-care system, says that the average number of patients being treated in “unconventional spaces” is one of several \u201cmeasures to be retired\u201d under an updated “Accountability Agreement” with the Ministry of Health.<\/p>\n “We track how the health system is performing using indicators set out in our Accountability Agreement (AA) with the Ministry of Health. This agreement, which is updated every three years, will be refreshed in 2025 to focus on what matters most to people in Ontario,” the agency’s report stated.<\/p>\n Ontario Health said that as part of its work to “track performance indicators,” which helps keep its focus on improving care for Ontarians, the agency updated the indicators to “move beyond those focused on COVID-19 recovery and to remove those with reporting delays.”<\/p>\n Other measures a footnote in the report stated would be “retired” include the percentage of hip and knee surgeries done within the recommended target wait times, adult cancer and non-cancer surgical volumes, the percentage of patients who visited an emergency department (ED) four or more times for mental health and addictions reasons, the proportion of virtual to in-person primary care visits, the number of patients accessing virtual care, the percentage of Ontarians with a virtual visit in the past year, the percentage of COVID-19 tests completed within two days and the percentage of cancer screening tests compared to pre-pandemic volumes.<\/p>\n Data for these measures were also not included in the 2024-25 annual report.<\/p>\n Asked whether it would still track these metrics, the government indicated that Ontario Health is still monitoring \u201cno-bed admits,\u201d mental health and addictions-related ED visits, cancer screening rates, surgeries done within the recommended wait times and more.<\/p>\n \u201cThe proportion of primary care visits that are virtual, proportion of Ontarians accessing virtual care, percentage of tests completed to pre-pandemic, and COVID test indicators are no longer tracked as they were solely to monitor care during the pandemic,\u201d said Ema Popovic, spokesperson for Health Minister Sylvia Jones.<\/p>\n \u201cTo be clear, outside of the annual reporting process, Ontario Health tracks key performance indicators to help ensure the healthy system is delivering high-quality care, this includes measures that have been highlighted in the Annual Report, but also many others,\u201d Popovic said.<\/p>\n She added that the measures included in Ontario Health\u2019s annual report \u201care those relevant to assessing the agency’s performance\u201d and that 21 new performance indicators were added in the 2024-25 report for this purpose.<\/p>\n This includes colorectal, cervical and breast screening participation rates and the number of days of physician coverage provided to communities in need.<\/p>\n \u201cI think that’s complete and utter malpractice in terms of public accountability and transparency for our biggest line item in our province’s budget,\u201d said Dr. Raghu Venugopal, an emergency physician in Toronto, of the government not publicly sharing hallway health-care data.<\/p>\n \u201cWhy hide the data? What does it achieve? Because nurses, doctors, patients, families know it right? \u2026 It’s our taxpayer money, we’d like to know how it’s being spent, where can we spend better,\u201d said Venugopal.<\/p>\n He said he hopes the Ford government decides to share the data publicly.<\/p>\n “The only reason you wouldn’t share data is shame, and I don’t think there’s a need to be shameful, because this actually is not a political issue,” he said. “It’s not one person that did this, it’s decades that did this, multiple administrations … it’s like an abscess, just say it’s there and open it and deal with it.”<\/p>\n He called the reality of hallway health care \u201cbrutal.\u201d<\/p>\n “I am one of thousands of doctors who can tell you that what happens because of hallway medicine is an affront to human dignity, a patient safety issue and just terrible medicine,” Venugopal said, adding that patients are having their undergarments changed or sensitive exams done in hospital hallways because of a lack of available beds.<\/p>\n Dr. Alan Drummond, an emergency physician in Perth, said he \u201cwouldn’t put it past this or any other government to try and hide key performance indicators that put them in a bad light,\u201d if that is in fact the intent of any change.<\/p>\n \u201cIt doesn’t matter whether they publish it or not. The reality of it is every emergency physician and every emergency nurse in this province knows that it’s not good, it’s not getting better anytime soon, and you can’t hide from it,\u201d said Drummond, who is also past chair of public affairs for the Canadian Association of Emergency Physicians.<\/p>\n Drummond said physicians are routinely treating patients in hallways, chairs, closets and other spaces around hospitals.<\/p>\n \u201cWe\u2019re frankly sick of it,\u201d he said. \u201cI saw somebody last year in a toilet. In a physical toilet, I examined a patient because I had no other space to see them.\u201d<\/p>\n Drummond said doctors at his hospital often see patients in an ambulance bay that has a window \u201cwide open to the entire world.\u201d<\/p>\n \u201cThere’s no pretext anymore of privacy, confidentiality or dignity \u2014 it’s all gone. We’re wiping people’s asses in hallways,\u201d he said.<\/p>\n Meanwhile, provincial opposition parties also slammed the government.<\/p>\n Dr. Adil Shamji, an emergency room doctor and the Liberals\u2019 critic for primary care, urgent care and public health, said the hallway health-care metric is important to track because the measure affects the flow out of the emergency department and how long people are waiting to see an emergency doctor.<\/p>\n The data should also be public, he said, because seeing the number of people not receiving “timely, dignified care … allows Ontarians to know what to expect and empowers them to demand better.”<\/p>\n NDP health critic France G\u00e9linas pointed to the 2018 promise from Ford’s Progressive Conservatives to end hallway health care.<\/p>\n “Eight years in government later and they\u2019ve decided hiding this data is easier than fixing the problems,” she said in a statement. “The quality of service our hospitals deliver is directly related to how many patients are receiving care in the hallway. If we want to fix this problem we need to properly fund our hospitals.”<\/p>\n In lead up to the Ford government’s 2026 budget, Ontario hospitals have been sounding the alarm about rising costs and “deepening structural” deficits, warning that “tough choices<\/a>” could be ahead and asking the province for more funding stability.<\/p>\n Venugopal said the ER-related statistics that are included in Ontario Health’s latest annual report \u2014 emergency department length of stay for all visits and physician initial assessment (PIA) wait times \u2014 are also important metrics.<\/p>\n “The three metrics that matter are how fast we see them, how fast we get them out of the ER, and then when we don’t succeed, what percentage of those are in unconventional spaces,” he said.<\/p>\n At the end of 2024-25, 10 per cent of patients stayed a total of more than 11.8 hours in the ER, up from 11.7 hours the year prior.<\/p>\n “Performance was impacted by factors including seasonal respiratory illnesses and the acute care system operating consistently above 100% occupancy, which impeded patient movement out of the ED,” the report stated, adding that “addressing ED wait times will be a focus for Ontario Health in 2025\/26 with targeted interventions to support performance improvements.”<\/p>\n The annual report also showed that 10 per cent of patients waited more than 4.6 hours to get assessed by a physician in March 2025, which Ontario Health said was a “major deviation against the year-end target of four hours.” It was also slightly more than the 4.5 hours reported the previous year.<\/p>\n “Wait times to PIA (physician initial assessment) impacts ED care quality, safety and the patient experience,” the agency stated.<\/p>\n Popovic, the health minister\u2019s spokesperson, said that PIA times improved between April and November last year, from 4.4 hours to 4.1 hours. She added that in 2024-25, the total number of ED visits decreased by nearly 200,000 and non-urgent ED visits were reduced to less than 13 per cent.<\/p>\n She attributed this to the government\u2019s \u201crecord investments\u201d in health care \u2014 including $91.5 billion this year \u2014 and its moves to expand primary care and allow pharmacists to treat minor ailments.<\/p>\n \u201cWe have increased funding by 4% to the hospital sector for a record 3 years in a row while investing $44 million to tackle emergency department (ED) wait times and $10 million to upskill 1,000 nurses to work in emergency departments,\u201d Popovic said.<\/p>\n Meanwhile, Shamji called the numbers in Ontario Health\u2019s report “unacceptably high.”<\/p>\n “What we’re seeing in terms of the emergency department wait times, whether you look at it as length of stay or time to initial physician assessment, these are terrible outcomes that really paint the picture of emergency departments that are straining in ways that have never been seen before,” he said.<\/p>\n The Trillium reported<\/a> in 2024 on internal government data showing that one in 10 patients admitted to an Ontario hospital from an emergency department waited\u00a0at least two days before getting a bed.<\/p>\n Additional reporting<\/a> showed that in January 2024, an average of 1,860 patients per day were kept in unconventional spaces in hospitals across the province \u2014 the highest number till that point since 2017.<\/p>\n