Summary of Bill 7

Bill 7 allows hospitals to transfer patients to long-term care homes, not of their choosing, without their consent. Patients who refuse to leave a hospital also face a mandatory fine of $400 per day. 

Patients designated as “alternative level of care” (ALC), who are waiting for another level of care after receiving acute care in hospital, can be moved to a LTC home that is up to 70 km away from family and loved ones, or up to 150km away if they live in northern Ontario. If there are no LTC homes with short waitlists or idle beds in northern Ontario, a Care Coordinator can move an ALC patient even farther. 

The government has fast-tracked the bill, shortened debates and skipped committees, therefore removing opportunities for public and stakeholder consultation. 

Some ALC patients are waiting in hospital for LTC and are part of the 40,000 residents waiting for one of the 80,000 LTC beds. They are typically elderly and suffer from multiple health conditions, making them vulnerable. 

ALC patients often lack capacity, with some being in their final months of life, and those admitted to LTC homes have a short life expectancy. Bill 7 allows clinicians to designate patients no longer requiring hospital care, but it does not provide any criteria or guidelines for making this decision.  

Bill 7 :

• targets vulnerable patients by depriving them of their right to informed consent about their living arrangements and healthcare. This will cause unnecessary suffering and hasten some patients’ deaths. 
• deprives ALC patients of their right to life, liberty, security of the person, and their right to consent to medical care.  
• denies them their right to appeal or seek review of the actions of hospital and provincial official 

These deprivations go against the principles of fundamental justice required by s. 7 of the Charter.  

Moreover, Bill 7 singles out a group of elderly patients, which goes against the right to equality under s. 15 of the Charter. 

To address the competing demands for acute care hospital beds and improve patient care, the provincial government should: 

• provide reliable home and community care services 
• increase funding and capacity for hospital services to better meet the needs of ALC patients,  
• increase funding and oversight of LTC beds to ensure quality care for all residents who require it. 

These solutions stand in contrast to Bill 7, which is not an effective means of addressing these issues. 

What does ALC mean? 

The ALC designation has been inconsistently applied, with some patients being mischaracterized as ALC and subjected to the deprivations of Bill 7 despite still needing hospital treatment. Most ALC patients want to return home or be admitted to an LTC home close to family and support, but face long waits due to high demand. As of January 2023, ALC patients occupy a little over 5% of Ontario’s in-patient hospital beds. 

ALC patients are casualties of a healthcare system that cannot provide the needed services due to government failures to provide home care services, properly staffed hospitals, and well-regulated LTC homes. These patients are not at fault and are suffering as a result.