CODE RED: One in Four Ontario Hospitals Facing Significant Cuts or Closure
Coalition Warns that Hospital Cuts Have Reached Crisis Levels
(Toronto) In a new report, “Code Red: Ontario’s Hospital Cuts Crisis”, the Ontario Health Coalition warns that Ontario’s hospitals are living in a permanent state of crisis, having been pushed by years of cuts into levels of overcrowding that are dangerous for patients and staff.
With the report, the Coalition released an interactive map of Ontario showing 51 hospital sites out of just over 200 hospital sites across the province that are marked as “Code Red”, denoting significant hospital cuts or threat of closure. This means that at least one in four of Ontario hospitals is experiencing significant cuts or closure.
Ontario is in its eighth year of real-dollar cuts to hospital global budgets. For the last three years, hospital global budgets have been frozen at 0% increases, which is in real-dollar terms a significant cut. After decades of downsizing, the cuts are biting ever more deeply into vital patient care services. The coalition is calling on the government to stop the cuts.
Key findings:
1. Many hospitals in larger communities are operating at 100% capacity or more – meaning all the beds are full and patients are lined up in stretchers in hallways. This puts hospitals into what is called “code gridlock” and staff are forced to discharge patients ever “quicker and sicker” to free up beds.
2. Internationally, the accepted evidence shows that a safe level of hospital occupancy is between 80% and 85%. Anything higher than this leads to higher rates of potentially fatal hospital-acquired infections, bed crises, backlogged and overcrowded emergency departments, patients lined in stretchers in hallways, inadequate clinical staff for patient load, long waits, ambulance offload delays and a host of other problems. These problems are frequently seen in Ontario’s larger towns.
3. Small and rural hospitals have faced disproportionate cuts and a number are at risk of total closure, despite overwhelming community opposition and dangers to patients.
4. Excuses such as “transforming health care”, “moving care to the community”, and blaming the bed shortage on Alternate Level of Care patients are simply cover for real hospital cuts to services that are not being – and cannot be — transferred to public health care services in the community. Too often, these are just cover for privatization of needed health care.
5. As small and rural hospitals experience devastating losses of service, patients find that the regional hospitals in larger towns have no capacity to take them either, as they too are being cut.
6. Ontario funds its hospitals at the lowest rate per capita of any province in Canada. Ontario has the fewest hospital beds left of any province in Canada and is near the bottom of the entire OECD in the number of hospital beds per population.
7. The true measure of affordability – hospital funding as a proportion of our provincial GDP – Ontario ranks nearly at the bottom of the country. We are 8th of 10 provinces.
The interactive map and full report are available at: www.ontariohealthcoalition.ca
Planned Closure of Five Hospitals in Niagara Puts Patients At Risk,
Warns International Health Expert
Coalition is Concerned that Niagara Closures Pave the Way
for Hospital Closures Across Ontario
(Toronto) An international health policy expert warned that the plan to close five hospitals in Niagara risks patient safety, “lacks any rational justification” and contains “glaring omissions”. Dr. John Lister, author of two books on global health reform and professor at Coventry University, joined a press conference at Queen’s Park from the U.K. by video conference today to give his analysis of the documents and reports used by the Minister and the LHIN to approve the closures of five communities’ hospitals across Niagara. His findings are contained in a report, “Niagara Health System: Under Threat” released by the Ontario Health Coalition, available at www.ontariohealthcoalition.ca.
Dr. Lister reviewed all of the publicly-published documents considered by the LHIN and Minister pertaining to the planned hospital closures in Niagara-on-the-Lake, Port Colborne, Fort Erie, Niagara Falls and Welland.
Key findings:
1. The plan to close Niagara-on-the-Lake’s inpatient hospital beds will drive up hospital overcrowding levels across Niagara to “dizzying heights” warned to Dr. Lister. Even before the planned closures, Niagara’s hospital overcrowding levels are far higher than internationally accepted standards for patient safety. Such cuts, Dr. Lister cautioned, would “create a system permanently living on the edge of crisis.”
2. With the closures, the Niagara Health System plan is to increase occupancy for complex continuing care beds to over 97%. Current occupancy for complex continuing care is over 93% according to LHIN documents. A safe level of bed occupancy is considered to be below 82%.
3. The Niagara Health System’s occupancy levels for acute care are 102%, placing the NHS among the most overcrowded hospitals in Ontario, according to a 2014 investigative report on hospital occupancy by journalist Jonathan Sher of the London Free Press.
4. Planned closures of complex continuing care beds are starting now in Niagara-on-the-Lake despite the extraordinary levels of hospital bed occupancy and the fact that Niagara has the second highest number of seniors but the second lowest number of long-term care beds per population, according to LHIN documents.
5. The report containing recommendations to close the hospitals approved by former Health Minister Deb Matthews, “is striking for its lack of even the most rudimentary analysis of local population and communities, demographic pressures, health needs, or logistical and access issues,” noted Dr. Lister. The regional LHIN failed to conduct an analysis of population need for care, did no environmental impact assessment for the plans to close five hospitals and transport all residents across the peninsula to a new greenfield site, and gave no consideration of the impact on ambulance services and transportation for patients, and a dubious costing exercise based on bed numbers that are unexplained. Furthermore, “no equality impact has been published.”
6. Dr. Lister reported that the provincial government appointed a Hospital Supervisor to address a c. Difficile crisis that had resulted in the deaths of more than 30 patients in Niagara’s hospitals, but the Supervisor’s report and recommendations offer “only one passing reference to hospital acquired infections” with no serious consideration of the reasons for the fatal outbreak, the problems containing it and what should be done to prevent future outbreaks.
7. Normal processes for plans that recommend such significant restructuring would include formal consultations, that are reported to the Minister and the public, which have not happened: “all we are left with is a vague reference to undefined advice from an improbably large number of individuals,” Dr. Lister reported.
8. Dr. Lister also warned about the immediate plan close the public hospital’s diagnostic services in Niagara-on-the-Lake and hand them over to for-profit companies, and the closure of needed hospital services many years before any new hospital is built.
9. Dr. Lister’s report notes that Kevin Smith’s report recommending the closures is unusual for its first-person style of writing and lack of evidence. After being appointed as hospital Supervisor, Kevin Smith replaced the Board of Directors and then was himself hired as CEO to the Board he put into place, while at the same time continuing his employment as CEO of the St. Josephs’ group of hospitals in Hamilton.
10. There is only $5 million difference in the costing between keeping all the existing hospitals open with needed refurbishments and closing five hospitals down; and this is before adding in the new costs for closing five hospitals, including the financing costs of a new hospital (which would likely entail a costly privatized P3 scheme) and additional new ambulance and transportation costs which would need to be added to get the total costs for the one-hospital model, reported Dr. Lister. He also found that there is no evidence in any of the reports regarding costs for operating the Niagara Health System under any proposed model.
The Ontario Health Coalition is deeply concerned that if five hospitals serving approximately 300,000 people in Niagara are closed, this paves the way for hospital closures all across Ontario.
The Health Coalition is calling on Health Minister Dr. Eric Hoskins, at minimum, to immediately stop the closure of the hospitals across Niagara, and restore the services that are currently being closed in Niagara-on-the-Lake.
~ Protecting Public Medicare for All ~
Ontario Health Coalition, 15 Gervais Drive, Suite 604 Toronto, ON M3C 1Y8
ohc@sympatico.ca
www.ontariohealthcoalition.ca 416-441-2502
