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Finding efficiencies and ensuring local residents have continued access to high-quality health care across the region were a few key points in a presentation to Simcoe County council Tuesday on behalf of the Simcoe County Hospital Alliance (SCHA).
Jody Levac, president and chief executive officer of Stevenson Memorial Hospital in Alliston, and also SCHA chair, updated council during its April 25 committee of the whole meeting on the impact of the alliance as regional and community health organizations, as well as its partnerships and what he called “unprecedented” challenges with capacity and health human resources in recent years.
The alliance was established in 2002 to advise the county of ongoing hospital capital needs and to ensure the county’s investment was equitably distributed, and includes the County of Simcoe as well as the seven hospitals providing health care to county residents in Georgian Bay General Hospital (GBGH) in Midland, Collingwood General and Marine Hospital, Orillia Soldiers' Memorial Hospital, Royal Victoria Regional Health Centre (RVH) in Barrie, Stevenson Memorial, Waypoint in Penetanguishene, and Southlake Regional Health Centre in Newmarket.
County councillors were given a snapshot of the numbers seen by the hospital alliance for the fiscal year of April 1, 2021 to March 31, 2022, which noted they had more than 340,000 emergency department visits, conducted more than 77,000 surgical cases, and spent more than $822 million in salaries and wages combined.
Levac also provided some insight on how hospital capital projects are funded in Ontario, noting traditionally the province covers 90 per cent of approved brick-and-mortar construction, leaving the remaining costs to be funded locally through hospital foundations and local municipal expenditures.
“With the added costs associated — furniture, fixtures and equipment — (those) are not funded by the ministry (and) the local share is realistically closer to 30 per cent, while the ministry is covering the remaining 70 per cent once the project is complete,” he said.
Levac also expressed concern about the inflationary costs associated with construction resources and supply issues stemming from the pandemic.
“Suffice it to say billions, not millions, will need to be invested in hospital infrastructure projects,” he said prior to showing council a slide summarizing hospitals' capital planning and approval process set out by the Ministry of Health for projects over $10 million.
“This journey is a marathon, not a sprint. The ministry has recently updated (this) process … (so) it’s now the equivalent of nine overall stages. While in large part it’s the same in terms of planning work to complete, the stages have been categorized into early planning, detail planning and finally construction. Government approvals are required along the way,” Levac added.
Levac also said alliance members are grateful the county opted to renew its funding to local hospitals in 2017, pointing out the county has invested $45 million in 15 years.
“At this time, the bulk of the allocation will go to Collingwood and Alliston’s Stevenson Memorial capital projects. Both of these hospitals are working diligently to meet milestones to meet their capital planning process," he said. "We also want to share our joint thanks for the $1.8 million in contributions being made to our hospitals for 2021. The County of Simcoe has continued to provide funding in support of our hospitals and we share a joint thanks for these critical contribution."
Despite all of the great things that have been occurring, the challenges facing local hospitals are deep, he added.
“Hospitals across the province have been experiencing significant pressure and challenges, and our region is no exception," Levac said. "Due to population growth in many of our respective communities emergency department volumes have seen a vast increase which has impacted wait-times.
"Occupancy rates … have also been extremely high,” he said, adding virtual care options helped ease some of that stress.
COVID-19 pressures still exist in hospitals, added Levac, pointing to ongoing outbreaks, the closing of many COVID, cold and flu clinics, and the province’s removal of COVID-expense reimbursement as simply a few of those pressures, while aging infrastructure and lack of space in hospitals also present many ongoing challenges. Health human resource challenges have also continued to escalate over the last three years, he said.
“I have never seen this in my career. As a result of the pressures brought on by the COVID-19 pandemic, staff are experiencing burnout, resulting in higher volume of sick calls, many early retirements and many staff are abandoning the health-care profession altogether,” he said.
“It’s no secret that our health-care system is facing extreme challenges. We know our capacity will not keep up with the population growth and the health-care demands that follow," Levac added. "In five years the quality of care we can deliver will undoubtedly fall below the recommended standard if we do not receive investments that are so needed."
That's why the alliance is requesting the county to revisit its agreement to ensure all residents can continue to be able to access the high level of care “where and when needed," he said.
Midland Mayor Bill Gordon pondered whether the possibility of amalgamating some of the local hospitals would help to reduce some of the financial pressures facing all of the local hospitals in the region.
“And all of our hospitals seem to be in the upgrade requirements and it’s hundreds of millions of dollars and costs that our small communities don’t have. It’s out of control," Gordon said. "It all has to be done and I get it … but you look down in the GTA area where you see hospitals basically merging so you don’t have the overhead of multiple boards, CAOs, chiefs ... they’re all high-priced help.
"Has anyone ever considered amalgamation of, say, GBGH and RVH so that it breaks up people’s fiefdoms?” he asked. “Has that ever been talked about as a possible solution, or is it that everyone is still circling the wagons and wanting to keep independent hospitals?”
Levac said the challenge with amalgamation is that each hospital has its own respective community board, which he added are often “tenacious” in protecting their community hospital.
“If you look across the province, smaller community hospitals that get amalgamated into larger systems, they’re not the same,” he said.
“I think we all feel pretty passionate about our hospitals. At the end of the day, it’s about saving lives,” said Wasaga Beach Mayor Brian Smith, adding he believes it is the provincial government that is “failing miserably” when it comes to supporting health care in Ontario.
“When is the province going to do what they’re elected to do and that is make sure that residents of our province get the services they pay for … and look after what’s most important, and I can’t think of anything more important than our health care," he added. "We need to collectively take the fight to the province.
"If the province is going to tout its 90-10 when it’s actually 70-30 … then we need to make sure the ministry knows we are all aware of that and they need to fix it.”
