Lack of Toronto hospital beds strands 88-year-old woman in Malta

An 88-year-old Toronto woman was stranded 7,600 kilometres from home after a medical emergency and a fruitless search for a hospital bed in the Greater Toronto Area, and her case should be a warning to future travellers, says her son.

Mike Pace’s mother, Carmen, was on vacation on the Mediterranean island of Malta in September when she had a stroke.

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To make matters worse, Pace said he and his family were told by his insurance company that there were no hospital beds available in Toronto or Mississauga to treat his mother.

After weeks of waiting, Pace said his insurance company presented him with an unusual option: his mother would be flown back to Toronto anyway and dropped at a local emergency room.

“It is stressful,” Pace told CTV News. “It’s created a lot of anxiety for the family abroad.”

Carmen Pace is transported by airplane to a St. Joseph's hospital in Toronto. (supplied)

Leaving a transfer patient at an emergency room is known colloquially as “dumping.” The travel insurance industry says it’s very rare, saying historically they bring back about 700 Canadians a year with a bed prepared for them.

“The last thing we want to do is bring someone back and leave them. Ideally we want to set that up,” Will McAleer of the Travel Health Insurance Association said in an interview.

But McAleer said serious problems in Ontario’s health-care system are making everything worse, expressing concerns that solutions have to be found.

“As hospitals get busier, it becomes that much more difficult for us to get individuals back home,” he said.

Even in the Mediterranean, the Paces were caught up in a health-care crisis that has closed hospital wards and ERs across the country. One major cause is a nurse shortage prompted by the stresses of the pandemic, which has pushed more nurses to retire or quit.

Data shows nurse vacancy have been rising at GTA hospitals, and twice as many Canadian nurses are leaving to work in the United States compared to five years ago.

“I have never seen it this bad, ever. Nobody has,” said NDP Health Critic France Gelinas.

Ontario’s Ministry of Health told CTV News it has registered some 4,000 internationally qualified nurses this year, and passed new regulations on Thursday that allow more internationally-qualified nurses to take shifts in hospitals while they wait for the applications to be completed.

ONTARIO'S HEALTH-CARE SYSTEM STRETCHED THIN

The holiday in Malta was supposed to be a trip of a lifetime for Carmen, Pace said. But everything changed when she had her stroke. She was rushed to a Maltese hospital on September 29, where she was stabilized.

Then, Pace began the steps to return his mother home, hoping that a familiar environment and proximity to family could help her recover more quickly.

“Unfortunately, I have been notified by the insurance company saying that beds in Toronto and Mississauga are at capacity. They have been declined. My mother has been declined a bed,” he said.

Carmen Pace is seen in this undated image. (supplied)

Even by October 13, emails show that the insurance company was still “working with St. Joe’s to get an accepting doctor and secure a bed.”

Other e-mails show the government of Ontario referred Pace to CritiCall Ontario, which is an agency that handles repatriations of patients in life-threatening situations.

That agency told CTV News it repatriated 29 patients in 2019, and nine so far in 2022.

"Is the system stretched? Yes, it is. Every day we hear of hospitals closing different beds or having human resourcing issues," said Isabel Hayward, CritiCall Ontario's executive director.

Hayward said that it has never not been able to find a bed for a patient who fits its criteria.

"Through CritiCall, the system continues to collaborate to mitigate risks and ensure access to care," Hayward said.

However, because Pace was stable in Malta, it appears she did not meet the criteria.

Mike Pace said the company offered to fly his mom back even without a bed ready, and drop her at the St. Joseph’s Hospital Emergency Room. He said she remains there, getting care.

Unity Health Toronto, which operates St. Joseph's Hospital, refused to answer any questions about the Pace’s struggle to get a hospital bed, despite repeated requests from CTV News and calls by her family for transparency.

Trillium Health Partners told CTV News they have completed five out of country repatriations this year. Another nine requests were received, said a spokesperson, but the reasons they didn't go through weren't to do with hospital capacity.

University Health Network told CTV News that an acute transfer from an international setting would happen one or two times a year. Scarborough Health Network said such a transfer would be rare, but that they would not have precise statistics on it.

A Unity Health Toronto spokesperson said, "Repatriation requests have not been declined at our sites where the patient met the repatriation criteria and also provided the appropriate medical documentation to support a transfer of accountability."

“It’s very frustrating,” said Pace. He believes other travellers should be warned of the possibility they could be stranded too.