The Ontario Superior Court of Justice on Monday began hearing a constitutional challenge to Ontario’s controversial Bill 7, the More Beds, Better Care Act. The challenge claims that the bill violates the Canadian Charter of Rights and Freedoms citing concerns about age discrimination, personal autonomy, and informed consent.

Bill 7 was enacted in September 2022 and allows hospitals to transfer discharged patients to long-term care homes without their consent. Patients who decline this transfer could incur a daily fee of $400. This measure aims to alleviate pressure on hospitals that are experiencing emergency department closures and significant surgical backlogs exacerbated by the COVID-19 pandemic.

The Charter challenge was brought forth by The Advocacy Centre for the Elderly and the Ontario Health Coalition. They argue that the legislation interferes with the right to life, liberty, and security by depriving ALC patients of personal autonomy regarding their medical care and living arrangements. In addition, the parties allege that the law violates patients’ rights to informed consent concerning their placement in long-term care facilities and infringes on patients’ right to protect their personal health information.

The Government of Ontario asserts that the bill does not violate Charter rights, arguing that it does not compel patients to move to any specific nursing home. They maintain that patients do not have a Charter right to remain in a hospital without charge after being discharged and that the Charter does not safeguard against the sharing of private health information in this context. Premier of Ontario, Doug Ford defended the law saying hospitals need bed capacity and that discharged patients should be in long-term care homes and not hospitals.

Since the law was enacted, data indicates that its impact and implementation have varied significantly across the province. The Scarborough Health Network reported that the law has facilitated the freeing up of beds for scheduled surgeries, while Trillium Health Partners moved 240 Alternate Level of Care (ALC) patients to nursing homes in just three months, resulting in improved patient flow. Meanwhile, rural hospitals such as Huron Perth Healthcare Alliance have reported minimal impact from the law, citing a shortage of available long-term care beds in their regions.

The constitutional challenge comes in the wake of broader issues within the Canadian public healthcare system, with increasing privatization measures being seen across the country.