Sophia, whose full name is being withheld for security reasons, brought her toddler to Scarborough Health Network’s (SHN) Kids After Hours clinic last Tuesday night after developing a fever of 107 degrees.
While filling out some paperwork to sign up for the visit, the single mother of two said she realized her son’s OHIP card had expired, but wasn’t too worried as they had made a hospital appointment a few days earlier without a problem.
“I didn’t think it would be a problem,” Sophia said, adding that she had heard that the SickKids hospital was experiencing overcrowding and long wait times, and wanted to try going to her local hospital first before going downtown.
The child’s expired health card became, in fact, a problem.
“The person at triage made a phone call and told me I would have to pay for the visit,” Sofia told CP24.com, adding the amount she was told she would be charged for her child to be seen by a doctor.  about $500.
Sophia, who has only recently returned to work after maternity leave and is struggling to cope, also claims she was mistreated by SHN staff during this extremely painful ordeal.
“I was frustrated, worried and scared.  … My anxiety was through the roof.  I felt helpless,” said Sofia, whose son was born prematurely and had many health problems.
“My child was sick and I just wanted him to get better… This shouldn’t have happened.”
Sophia said she plans to file a lawsuit against the hospital.  He also said that he is in contact with some local politicians about possible further escalation of the matter.
“(Scarborough General) needs to know how their staff treat people,” he said.
“I don’t want another parent to go through what I went through.”
Scarborough Health Network spokesperson Leigh Duncan said their policy is that a patient with an expired OHIP card “will not be asked to pay out of pocket before being seen”.
“We do not refuse to see patients without a valid health card, even if it is expired,” Duncan said, adding that SHN does not refuse services to “patients in need” even if their health card is expired.
“While we cannot comment on a specific case without the patient’s consent, we always strive to provide excellent care.  We apologize if the patient experience did not meet these high standards,” he added.
Sophia, meanwhile, said she was never officially denied service at Scarborough General, but was instead told she would have to pay out of pocket to receive it.
After contacting Community Angels Toronto, a grassroots network based in the city’s east end that helps bridge the gaps, for help, the mother and son were able to take an Uber to SickKids where they saw him several hours later without issue, she said Sophia.  The child is now well.
“What happened is infuriating and upsetting,” said Cindy Monk-Fuller, the group’s founder.
“I can’t believe (Sophia) was turned away (from free care) because of an expired OHIP card.  They treated her badly, like a second-class citizen.”
Monk-Fuller said what happened was a “terrible example of a system collapsing”.
“Everyone in the health sector is stressed.  This is such an unfortunate situation,” he added.
In a statement provided to CP24.com, Ontario Ministry of Health spokesperson Bill Campbell said this issue could easily be addressed as “most expired and expiring health cards that are valid can continue to be used for access to insured health services”.
“Health care providers are encouraged to validate health cards at the point of service using the department’s health card validation mechanisms to ensure the card remains valid,” he wrote, noting that people who are unsure of the validity of their health cards will they should call the ServiceOntario INFOline at 1 -866-532-3161.
Campbell further noted that under the Excellent Care for All Act, every Ontario hospital is required to have a patient relations process to address patient and caregiver concerns.  He urged any patient with a complaint to start by contacting the hospital’s patient relations office.
“The Ministry of Health does not play a role in the management of hospitals.  For more information about the day-to-day management of a particular hospital or its patient relations office, you may want to contact that hospital directly,” he said.