Winnipeg Free Press - PRINT EDITION

Hospitals spent $125,000 to send patients home by taxi last year

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In the big picture, $125,000 may be a mere drop in the bucket for a city hospital system that costs taxpayers a little more than a billion dollars each year to operate.

But that's what Winnipeg health-care facilities spent last year on taxi fares for patients.

The Free Press obtained the cost -- and a breakdown for each hospital -- through a freedom of information request. Also requested was the number of taxi trips paid for by the institutions.

However, the Winnipeg Regional Health Authority said in a written response this week the information on the number of trips was not available.

"The sites (hospitals) do not routinely track the number of taxi trips for patients, therefore no record exists and access to these records is refused ..." stated a letter signed by WRHA president and CEO Arlene Wilgosh.

There were wide disparities between hospitals in the amounts spent on patient taxi rides -- disparities that reflect the size and the wealth of the geographic areas served.

Seven Oaks General Hospital and Health Sciences Centre, with expenditures of $34,897 and $29,366 respectively, spent the most on cabs last year, while Victoria General Hospital shelled out the least at just under $7,000. The Free Press requested the information in light of two recent incidents in which Grace Hospital patients died after being sent home in city taxicabs. Neither 62-year-old Wayne Miller nor 78-year-old David Silver made it inside their front doors after they were dropped off. The deaths prompted critical-incident reviews and the promise of a more rigorous emergency-department discharge process. In the future, cab drivers will be given specific instructions if patients need assistance entering their home.

Lori Lamont, the WRHA's vice-president of inter-professional practice and chief nursing officer, said the figures represent the cost of cab rides for patients from the hospitals as a whole -- not just from emergency departments.

She emphasized that in "the vast majority" of instances, patients arrange and pay for their own rides home.

The hospitals will pay, she said, "when there aren't a lot of options for transportation and the individual indicates that they're unable to pay for a cab."

Lamont said there is not one citywide policy for determining when a hospital will pay the cost. Those decisions are made by the institutions themselves -- usually by a social worker or a charge nurse.

And the paid-for rides don't occur only when patients are discharged late at night.

For instance, if a volunteer transported a cancer patient to hospital for treatment and treatment was delayed -- making a return ride with the volunteer impossible -- the hospital may feel obliged to send the patient home by cab at its own expense, she said. "In that case, we would feel that it's our fault and so the staff would issue a taxi voucher for them."

Hospitals used taxi company invoices to track the amount they spent on cabs for the Free Press. An official with Unicity Taxi, contacted on Friday, refused to comment on how detailed the invoices are or whether each fare is listed.

Asked why the institutions don't keep track of the number of trips they cover, Lamont said the hospitals lack the "information system" to do that.

"It's not a small amount of money," Lamont said of the $125,000 spent last year. "But in the big scheme of things, how much money do we invest in tracking something that is a (comparatively) low cost?"

According to a taxi-industry source, the average Winnipeg fare is about $10 to $11. At $11 per ride, the $125,000 spent by the hospitals could have ferried 11,363 people home -- or 218 a week. At $25 per fare, the total would have been 5,000 for the year or nearly 100 a week.

Progressive Conservative health critic Myrna Driedger said she's surprised the health system isn't keeping track of how many people it is paying to drive home.

She said the PCs have asked for similar information in the past, and the numbers obtained by the Free Press this week suggest the costs of providing taxicab rides may be soaring.

In 2011-12, Health Sciences Centre spent $14,564 on taxis for "discharged patients," according to information obtained by the Tories. But from April 1, 2012, to March 31, 2013 (the government fiscal year), it spent double that on patient rides -- more than $29,000.

Lamont didn't have costs for previous years at her fingertips on Friday. But she said the bulk of the fares accounted for in the cost totals would have been for rides home for patients -- as opposed to sending them to another health facility.

She also said the totals provided to the newspaper do not count taxis paid for by the federal government for status Indians or fares paid for by the province for patients on social assistance.

Meanwhile, Driedger said it is unfortunate so much attention is being focused on the taxi industry in light of the deaths that occurred this past December.

When the matter came to light in early January, Health Minister Erin Selby's immediate reaction was to focus on taxi drivers, saying they would be given responsibility for ensuring discharged hospital patients make it home safely.

Driedger called the health minister's reaction "bizarre."

"I think it was a really inappropriate response, because what it's done is that it's detracted from the more serious issue of why people died just minutes after being discharged," she said.

The focus should be on whether existing discharge protocols were followed and whether those protocols should be improved, Driedger said.

larry.kusch@freepress.mb.ca

Republished from the Winnipeg Free Press print edition February 22, 2014 A6

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