Thread by @AlexMunter

Why the current crisis in 🇨🇦's children's hospitals?
A short 🧵 on how we got here and what needs to happen next.
@CHEO had 300 beds when it opened in 1974. Today there are fewer than half that many.
That started out as a good-news story.
#cdnpoli #onpoli

Advances in pharmacology = fewer kids need hospital care.
Advances in day surgery = only 20% of kids at @CHEO need a bed after surgery.
Vaccines = less infectious disease.
Helmet laws, seatbelts and other public health rules = less injury.
Better prenatal care = healthier babies.

All good stuff.
But there are more kids (Ottawa's child+youth population is now growing 9x faster than Ontario's).
Mental health, behavioural diagnoses, childhood obesity all way up.
Whole new diseases have emerged (Covid, H1N1).
Better prenatal care means more preemies survive.

This growing need for children's healthcare collided with a drive by government to "bend the cost curve" of hospital budgets.
So as demand for care at pediatric hospitals like @CHEO grew, our resources shrank.
mykawartha.com/news-story/551…

Pre-pandemic, the children's health system was *already* too small. Too many kids waited too long *if* they could wait.
But some couldn't. Critically-ill kids were shipped around Ontario like Amazon packages because there were so few pediatric ICU beds.
cbc.ca/news/canada/ot…

Pre-pandemic, 35% of kids waiting for surgery at @CHEO waited longer than is clinically safe.
That's now 50% and will go higher because the current respiratory viral surge is causing cancellation of surgeries to free up staff to care for sick kids.
ottawacitizen.com/news/local-new…

By 2019, #Ontario was in last place among western jurisdictions for the number of acute care hospital beds per capita.
The child+youth health system is too small to deal with regular demand, let alone this unprecedented surge (no one at @CHEO has ever seen anything like it).

Dejected yet?
Don't be.
There *are* solutions!
Since 2020, there's been much expansion across the system, including at @CHEO. New beds, OR time, more outpatient services.
We are now running well over 100% of that *expanded* capacity.
So step 1: Keep expanded capacity in place.

Step 2: We must right-size the system.
🇨🇦's population of children is growing.
Investing in kids' health is the right thing to do, pays dividends to the whole society and reduces health costs later.
Some of us have been saying this a long time.
This is a teachable moment.

#Ontario children's hospitals, mental health agencies and rehab centres have an affordable plan to catch up on backlogs that are hurting so many kids.
Hopefully today's federal-provincial-territorial meetings will earmark funds for kids' health, including a dedicated HR strategy.

Meanwhile we focus on the current crisis.
Thank you @CHEO staff, physicians, learners and volunteers. You are amazing. ❤️
Thank you to all @OntarioHealthOH organizations helping us.
Everyone: please mask indoors, including schools. Get vaccinated.
Sick kids are counting on you.