Health Blog

Ontario’s Health Care Landscape

In the context of Ontario’s healthcare system, a number of key institutions play a vital role in ensuring the wellbeing and representation of patients. These include the Ministry of Health and Long-Term Care, the Local Health Integration Networks (LHINs), and the Psychiatric Patient Advocacy Office (PPAO). Despite the invaluable resources they offer, navigating the abundance of information available can be a challenging endeavour, particularly for those lacking the requisite expertise.

Insights into the Framework

The province of Ontario has enacted legislation requiring all hospitals to appoint a patient advocate. This mandate is enshrined within the Excellent Health for All Act. While each hospital develops its own grievance redressal mechanism, the feedback procedures provided on their respective websites are often lacking in detail. This lack of transparency is regrettable, particularly given the complexity of Ontario’s regulatory framework for lodging formal complaints. Familiarising oneself with Ontario’s healthcare governance can provide clarity amidst the complexity of the province’s healthcare system.

The province is divided into 14 LHINs, which are analogous to the Regional Health Authorities found in other provinces such as Nova Scotia and British Columbia. Each LHIN serves as a local liaison for healthcare service providers, including hospitals. In Ontario, public hospitals typically provide in-house patient advocacy services through their Patient Relations Department. Nevertheless, for individuals admitted to psychiatric facilities within these hospitals, access to an external advocate is also available through the provincial PPAO. In contrast to hospital-based advocates, the PPAO operates as an independent entity, serving as the sole full-time advocacy service for psychiatric inpatients across the province.

Long-term care facilities in Ontario are required to adhere to the Long-Term Care Homes Act, which mandates the provision of a clearly delineated complaints procedure. Furthermore, individuals may submit grievances via the ACTION line or by lodging complaints with the Director of the Performance Improvement and Compliance Branch at their Local Service Area Office, which is overseen by the Ministry of Health and Long-Term Care. Ontario offers a diverse range of recourse avenues, with service areas spanning Toronto, Hamilton, London, Ottawa, and Sudbury. Long-term care residents, who are considered both patients and tenants, are entitled to a distinct set of rights that reflect this dual status.

Navigating the Complaints Terrain

Non-Psychiatric Hospital or Health-Service Treatment Grievances

  1. Initial recourse involves directly engaging with frontline caregivers, such as nurses or physicians, who possess firsthand insights into the situation. Direct communication with involved parties often expedites issue resolution.
  2. In instances where resolution is elusive at the point of care, contacting the relevant area manager is advisable. Managers typically facilitate dialogue to address concerns in a timely manner.
  3. For complaints pertaining to hospital care, contacting the hospital’s Patient Advocate is recommended. Contact details for Patient Advocates are often accessible via hospital websites or the Patient Relations Office.
  4. In the absence of a designated Patient Advocate, reaching out to the hospital’s President or Chief Executive is warranted. Such contact information may also be available online.
  5. Should the preceding steps yield unsatisfactory outcomes, recourse to the LHINs is viable. Contact information for LHINs can be sourced from their respective websites or through the “Find your LHIN” feature.

Note: The Ontario Office of the Ombudsman presently lacks jurisdiction over general hospital complaints. Non-psychiatric hospital complaints received by the Ombudsman will be redirected accordingly.

Psychiatric Treatment Grievances in Hospital Settings

Steps one through three mirror the process outlined above.

The Mental Health Act affords psychiatric hospital patients access to external recourse via the PPAO (refer to Background section). Should resolution prove elusive through hospital channels, contacting the PPAO is recommended. The PPAO website offers a wealth of information catering not only to mental health patients but also to the broader Ontario populace.

Timelines and Appeals

Complaints are typically acknowledged within 48 working hours. Hospitals strive to facilitate a swift resolution, although the intricacy and scale of the investigations may influence the timelines involved. Once a resolution has been reached, the investigating party is obliged to inform the complainant accordingly. It is evident that hospital websites lack explicit details on appeal procedures. Should a grievance persist, it may be escalated to a relevant professional body, such as the College of Physicians, or adjudicated by an entity such as the Health Professions Appeal and Review Board.

Those seeking to navigate Ontario’s healthcare complaint mechanisms must be prepared to exercise patience and persistence. An understanding of the intricacies of available recourse channels empowers individuals to advocate for their rights effectively.