Because of cuts, hospitals continue to transform

By MPP Toby Barrett

Hospital bed cuts, service cuts, funding cuts, and downsizing – this was a common theme from nurses, physicians and patients testifying before this winter’s province-wide tour of the Standing Committee on Finance and Economic Affairs.

Ontario hospital budgets have remained virtually frozen over the past five years – five years of a growing and aging population with ever-increasing complex needs, skyrocketing electricity and energy costs, price hikes for drugs and medical supplies, the pressure of arbitrated wage settlements, and burgeoning red tape.

In a pre-budget submission the Ontario Hospital Association (OHA) states, “The population aged 65-plus has been growing at a much faster rate and will reach 25 per cent of our population over the next 25 years.

The OHA reports 15.5 per cent of all hospital beds are taken up by patients who should be receiving care in another more appropriate setting. These patients and their families are unable to receive the complex care they need in the community. Therefore, they are unable to leave hospital.  Action is needed to allow hospitals to meet the growing needs of these complex patients while they remain in care, and to minimize the impact they have on the ability of hospitals to admit patients in need of acute care.

Home care patients, meanwhile, are falling through the cracks. According to Ontario’s Auditor General only 61 per cent of home care dollars go to frontline service — the rest goes to administration. The Auditor General reported LHINs are failing to meet their mandate and are not integrated – and now we see them rewarded with additional power through the Patients First Act and the creation of 80 sub-LHINS.

Energy costs, especially for electricity, are putting a tremendous strain on hospitals. Further, the Ontario government’s new cap-and-trade policy, which took effect Jan. 1, has also had an upward impact on energy rates  – with one local hospital estimating a 16 per cent hike on natural gas.

The CEO of a small hospital reports: “Rural and remote hospitals are experiencing cost pressures for utility and food costs that are far in excess of overall provincial inflation rates…In spite of a number of innovative efficiencies and strategies implemented over the past two years, our hospital is projecting costs for hydro, natural gas, water and food to rise by some 19 per cent…”

Over 200,000 people work in Ontario’s 145 hospitals and compensation costs currently account for up to 70 per cent of hospital budgets. Increases for unionized professional staff add up to 6.95 per cent since 2011.

I am also told cuts to the Ministry of Health funding formula penalizes medium-sized hospitals like Strathroy-Middlesex, Leamington, West Parry Sound and our own Norfolk General.

Over the past four years, hospitals have shown tremendous leadership in making their operations more efficient, in light of per capita funding for Ontario hospitals being second lowest in the country. Ontario has the fewest beds per capita nationally and the average length of stay is the lowest of all the provinces.

Hospitals have recognized they can no longer work in silos and have created meaningful partnerships with community, long-term care and primary care providers. They have made difficult decisions about mergers to more efficiently deliver care. This ability to transform and adapt has made our hospitals more resilient and stronger than ever before.