Ontarians file record number of complaints to patient ombudsman in 2023-24

Ontario's patient ombudsman received a record number of complaints last fiscal year, with quality of health care and communication among top concerns.

In its latest annual report, the patient ombudsman says it received 4,429 complaints from patients, residents and caregivers about public hospitals, long-term care homes, home care and community surgical and diagnostic centres in 2023-2024. That number includes more than 400 complaints involving mental health and addiction services.

The total compares to the 4,388 complaints it received in 2022-2023. The office, which opened in 2016, was set up to help resolve health care complaints from Ontario patients.

Patient Ombudsman Craig Thompson said in an interview with CBC News on Wednesday that the growing number of complaints is not necessarily bad news.

"I'm very optimistic that things are getting better and particularly because of the results that we see with our work," he said.

"Complaints going up for me has never been a metric of whether something's getting worse or better. I've always believed that a healthy system will have complaints because that's one of our best feedback mechanisms. And so I've always wanted to see more complaints. I don't see it as getting worse."

The report says the patient ombudsman also resolved 4,575 complaints, which includes cases from the previous year, and opened six investigations, two of which were completed.

But it says it tracked a growing number of complaints about obstetrical and gynecological care, including complaints about "insensitivity, poor communication and lack of responsive care for pregnancy complications, miscarriages, difficult births and sexual assaults." 

Because its mandate expanded under new legislation, it also received complaints about community surgical and diagnostic centres, with most complaints about these clinics concerning communication, delays, problems with communicating test results and "insensitive, disrespectful care."

Continued problems in emergency departments

Thompson said the report highlights continued problems in emergency departments, discharging patients from hospitals and no trespass orders.

But he added that if an interaction leaves patients with the impression that staff are being insensitive or are appearing not to care, then "that just for me just sort of indicates that there's something not working" in that situation.

"People who are drawn to the health care world are caring people that want to do their best and to help patients, residents and long term care and their families. And so when you see that there's a failure at that sort of fundamental level, it really makes us take notice and wonder what is causing that."

Thompson said the office always looks at both sides of the complaint. It gives the complainant a chance to tell their story, then goes to the organization to find out what its experience was and if there was a breakdown in the relationship between health care provider and client. The office then tries to find out what needs to be done to address the complaint.

"Fundamentally, we should be curious as to why that happens and try to make changes so that it doesn't happen again," he said.

Youth mental health patient discharged without plan

Among the complaints received was one from the family of a young person with the developmental age of a five-year-old who spent a month in a pediatric mental health unit of a large regional teaching hospital after assaulting a parent at home. The parent told staff they didn't feel safe bringing the child home with sufficient support. 

The clinical team, after failing to create a hospital discharge plan that was satisfactory to the parent, discharged the youth into the care of the Children's Aid Society despite being told by CAS that it had no child protection issue that warranted its involvement. 

"Two hospital nurses escorted the youth to the CAS office by taxi and left the youth in a waiting room without transition of care instructions for the receiving staff, no prescriptions for the youth's medications, and no safety plan for supporting the parent to bring their child home," the report says. 

The patient ombudsman made six recommendations to the hospital, including that the hospital revamp its discharge policy to give advice on pediatric patients, that staff be trained on hospital regulations and the role of the CAS; and that the hospital create a "formal escalation process" with CAS and other community agencies.

Another complaint involved patient who miscarried

In another complaint, a complainant was referred to a community surgical and diagnostic centre for an urgent ultrasound after suffering miscarriage symptoms, including abdominal pain and heavy bleeding.

"When the complainant arrived at the centre, she told the sonographer this would be a difficult appointment for her. The complainant shared that the sonographer showed no compassion and did not explain what the procedure would involve," the report says. 

"After the procedure, the complainant attempted to discuss her concerns about the sonographer's lack of compassion and communication. The sonographer responded that they were not allowed to show compassion and focused on their inability to share the results of the scan, which was not the patient's primary concern."  

The patient ombudsman called the centre to make sure it was aware of the patient's concerns and would follow up. It then encouraged the patient to return to the patient ombudsman if she was not happy with the centre's response.

No data on LTC placements not of patients' choosing

As for new Ontario legislation designed to speed up the transition of hospital patients to long-term care homes, the patient ombudsman found the province is not keeping data on the transfers.

"Public reporting was not available on the number of people that have been placed in long-term care homes they did not choose, or the number of people charged the $400 per diem for refusing to accept a placement.

"Nor is there public data about the impact on the wait times for people seeking placement from the community," the report says.