‘I have never seen it this bad’: Hospital officials are desperate about their financial uncertainty, opposition MPPs say

Most are reluctant to speak publicly about the financial uncertainty they are facing right now, but behind closed doors many Ontario hospital officials are desperate, opposition health critics say.

“Many of them are worried about how they are supposed to continue their operations and respond at a time when they are facing unprecedented pressure,” said Dr. Adil Shamji, who is the Ontario Liberal caucus critic for health.

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Shamji said he was hearing about hospitals that were considering limiting surgeries amid financial insecurity and pressure from emergency department and hospital overcrowding.

“At a time when pressures in our emergency departments and our patient care are at their highest, hospitals need the funding in order to be able to respond and serve our communities. The big risk is that they do not have the capability and the funding in order to do so and at the end of the day, there are lives on the line.”

He said the province’s willingness to allow hospitals to “hang by a thread” was a damning indictment of their risk management and signalled their satisfaction with the status quo.

“The near universal state of hospitals running deficits in our province is frankly unprecedented,” Shamji said.

This newspaper has reported that the vast majority of the 140 hospitals in Ontario are projecting deficits this year. In addition, some have taken out high-interest loans to keep going and others have had to dig into reserves earmarked for specific projects.

The Ontario government has issued special waivers to most hospitals allowing them to carry deficits, the Ontario Hospital Association says. Hospitals in the province are, under normal circumstances, required to balance their budgets and such waivers are rarely used.

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“I have never seen it this bad,” said France Gélinas, who is health critic with the Official Opposition NDP.

“I have had many CEOs call me directly and had long talks about how desperate they are, and so are their boards,” she said.

The situation is particularly dire in the North and among rural hospitals, which increasingly rely on agency nurses to remain open — that costs the hospital significantly more than they pay regular staff.

At some locations in the North, nursing agency representatives sit in the parking lot and hire nurses as they are leaving their shifts at the hospital.

“The next day the nurse comes in at twice the wage. It is the same nurse that has been there for 10 years and now doesn’t have to work night shifts or weekend and can pick and choose her shifts,” Gélinas said.

It then becomes more difficult to fill those shifts and nursing agencies charge hospitals a premium to hire temporary nurses to do so, exacerbating a hospital’s financial strain, she said.

Gélinas has tabled a bill calling for regulation of private nursing agencies.

A key issue for all hospitals is that the Ontario government has not fully reimbursed them for retroactive payments to hospital staff covered by the wage restraint legislation Bill 124, which was declared unconstitutional by the courts.

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Last month the Ontario Hospital Association wrote to provincial officials urging them to fully reimburse hospitals for the retroactive payouts, but the OHA also said the worsening financial woes facing the province’s hospitals go beyond those payments and reflect years of underfunding. Ontario has the fewest hospital beds per population among Canadian provinces and the lowest rate among countries followed by the Organization for Economic Cooperation and Development (OECD).

The discontinuation of special pandemic-related funding last year, even as Ontario is experiencing one of its biggest pandemic waves, has added more stress to hospitals. OHA president and CEO Anthony Dale said he thought that COVID-19 should continue to be a “fixed cost” for hospitals for the foreseeable future.

Shamji said he wanted to see the provincial government come forward with funding for the retroactive payments, to restore pandemic funding and to regulate temporary nursing agencies.

He also noted that performance in emergency departments across the province was directly linked to “inadequate funding.”

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Gélinas, too, says she fears for patient safety, given the current situation.

“The biggest file for the provincial government is health and the biggest health file is hospitals. I can’t believe this is where we end up in Ontario,” Gélinas said. “It shouldn’t be like this. And I have no doubt that people’s lives and health will suffer.”

The Ontario Ministry of Health did not respond to requests for comment.

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