The president of the Canadian Medical Association says solutions to overcrowded hospitals lay in home-care and long-term care, rather than beefed-up hospitals.

“We think that if we can fix seniors’ care, it will go a long way toward fixing what’s wrong with health care in the country,” said Dr. Chris Simpson, addressing doctors at the Yukon Medical Association’s annual general meeting last Friday afternoon.

“We don’t have a health care system that’s designed to deal with chronic diseases like diabetes and dementia and heart disease and lung disease.”

Simpson noted older individuals are more likely to fall prey to chronic diseases, rather than acute problems, “whereas hospitals are for people with acute illnesses.

“What we want to do is find ways to build the infrastructure and the community to look after people with chronic diseases better and free up the hospitals to do what they’re supposed to be doing, which is acute care,” Simpson said in a post-speech interview at the High Country Inn.

His remarks followed a drawn-out, anger-spiked question to Premier Darrell Pasloski — who also addressed the gathering along with Health Minister Doug Graham — by Dr. David Storey, one of four general surgeons at Whitehorse General Hospital (WGH).

Storey asked why little was being done in the short-term to free up surgical recovery beds for elective operations patients.

Several have been turned away at the door this year, in some cases because the beds were occupied by long-term care patients, he said.

Palliative care patients have also been sent packing, transported to Watson Lake due to a lack of space at hospitals and long-term care facilities in Whitehorse.

For solutions, Simpson pointed to Europe, “where they’ve managed to deliver better quality care for cheaper.”

He identified Denmark, which has invested in home care at a rate five times that of Canada, as the poster child for efficient health services and adapting to the needs of an aging population.

The Copenhagen-based public health system there has not added new long-term care beds in two decades, and has even removed thousands of acute-care beds “simply by shifting the focus on delivering the care where seniors need it, which is in the community and in their homes,” he said.

Simpson, the medical director of the cardiac program at Ontario’s Kingston General Hospital, said his own institution faces similar problems to WGH.

Last month at Kingston General, 18 of 31 days — nearly 60 per cent — were spent in “gridlock,” meaning all beds were full.

Scores of patients were waiting for long-term care facilities, home care “or really should never have been there in the first place,” Simspon said.

“No elective surgeries got done. No transfers came in from the periphery to our tertiary care centre.

“The whole place was basically shut down for 18 of the 31 days, simply because we’ve got people in the wrong place.”

“Hospitals are toxic for people with chronic disease,” added Simpson, also a professor of medicine and chief of cardiology at Queen’s University.

“We put these people to bed — because that’s what we do in hospitals — instead of lifting them up and restoring them and helping them live a dignified life at home.”

He summed up his recommended strategy: “de-hospitalize the system.”

The Yukon government announced last July it would move ahead with a $72-million Whitehorse hospital expansion, now underway. It includes a new emergency department, shell space for more beds and an MRI (magnetic resonance imaging) program.

The two-storey WGH renovation is slated to include 17 treatment spaces on a 2,200-square-metre (23,700 sq. ft.) footprint along the east side of the current building, cutting into the parking lot.

Above it will sit a slightly smaller space with 10 new in-patient beds. How exactly those beds will be used is not yet determined.

At the meeting last Friday, Pasloski noted health care takes up one-third of the government’s operations and maintenance budget.

“I’m not going to back down saying that I think we have an incredible health care system,” he told the assembled doctors.

Pasloski also pointed to the new Alexander Street seniors’ residence, which had its ribbon-cutting ceremony this morning.

The Yukon currently has four long-term care facilities — three in Whitehorse with 182 beds and one in Dawson City with 11 beds.

A planned 300-bed continuing care facility, with a price tag of around $126.2 million, is still years away.

Described by Graham as a “huge, huge building construction project,” the plan has been criticized by the Opposition as over-centralized and lacking in public consultation.

Last March, more than two dozen patients were on a waiting list for continuing care.

A report from June 2013 by Kobayashi + Zedda Architects notes the Yukon will need upwards of 320 new continuing care beds by 2021.

The need to replace the 1970s-era Macaulay Lodge and the Thomson Centre – just 22 years old – will also factor into the number of new beds needed, the report notes.

During building reviews, the writing team found that Macaulay Lodge does not meet the building code for its current use.

The Riverdale facility scored under 50 per cent on the technical assessment and has a 7.5-year life expectancy.

Some suites and numerous bathrooms at the lodge are too small for a wheelchair to manoeuvre, one of several difficulties with the space.

Since the report was published, the Thomson Centre has reverted back to the Yukon Hospital Corp., no longer the responsibility of the Department of Health and Social Services’ continuing care branch.

Graham has said the expected new facility — 59,000 square metres (194,000 sq. ft.), and initially holding only 150 beds but with room for expansion to 300 — will eventually replace the beds at the Macaulay and Thomson facilities.

The government-commissioned report also stresses the need for various types of care that should be incorporated into the continuing care hub.

These include respite care, specialized secure care for residents with dementia, palliative care, day care programs, stabilization and assessment facilities, facilities for obese patients and mental health facilities.