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New Niagara Falls hospital won't solve local health care problems

What Niagara and hospitals across the province need is increased staffing; 'Workloads are just not doable'
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Canadian Union of Public Employees senior hospital researcher Doug Allan, left, and Michael Hurley, president of the union's Ontario Council of Hospital Unions, share details of a report about problems in Ontario's hospitals during a press conference Thursday in Niagara Falls.

A new $3.6-billion hospital planned to be built in south Niagara Falls within the next four years won’t be a local solution to backlogs and hospitals being overwhelmed with patients – a problem being felt across the province.

That’s according to Michael Hurley, president of the Canadian Union of Public Employee’s Ontario Council of Hospital Unions, and the union’s senior research officer Doug Allan, who were in Niagara Falls Thursday to reveal a 21-page report called The Hospital Crisis: No Capacity, No Plan, No End, citing data from Statistics Canada and the Canadian Institute for Health Information.

Hurley said Niagara has been “hammered” in recent years due to the province reducing services at local health care sites, such as Fort Erie and Port Colborne’s urgent care centres, which have recently seen a significant reduction in hours of operation, as well as after-hours emergency services shut down at Welland Hospital.

Niagara-on-the-Lake's hospital site closed its doors in 2015.

People from smaller towns and cities in the region deserve access to health care in their own backyards – not just those in Niagara Falls and St. Catharines – where a new hospital opened about 10 years ago, the report says.

“There’s a fondness for these mega hospitals, but there’s a vibrant role played by community hospitals,” said Hurley to members of the local media Thursday.

Allan said Niagara needs more than 1,700 staff dedicated to inpatient services than what is what currently offered, and another 223 beds over the next four years to address a “very serious problem” in the region and the rest of the province. Hurley said although a new state-of-the-art facility is expected, the real problem is inadequate staffing.

“If it’s not staffed – it's of no use,” he said.

“People are retiring, and people are walking away from the profession,” he said referring to the importance of job retention in healthcare and creating additional positions.

He said local sites “save a lot of lives” in smaller, rural communities, citing industry, highways where many accidents occur, and farming as reasons why local facilities need to be protected.

Turning them into outpatient clinics and offices for family physicians is “completely impractical and dangerous,” said Hurley.

According to the report, Ontario has 33,775 fewer positions in its hospitals compared per capita to other provinces, which equates to about 18 per cent fewer workers.

“Something different is happening in Ontario,” said Allan.

The largest part of the staff deficit for Ontario is in nursing and inpatient services, says the report that was released Thursday.

Ontario has 0.285 full-time equivalent workers per 100 population in inpatient services compared to 0.395 in other provinces across Canada.

“If Ontario had the same ratio of inpatient health care workers, there would be another 16,201 full-time inpatient jobs in our hospitals. That would allow a lot more hospital beds and inpatients and would help solve the capacity crisis we are currently experiencing,” reads the report.

To address the needs in Ontario, brought on mostly by growth and an aging population, 8,000 new beds are required over the next four years, not 1,000, which the province is suggesting, according to Hurley and Allan.

“Workloads are just not doable” at Ontario hospitals, as doctors, nurses and other providers are feeling a sense of “despair, defeat, and exhaustion” by having to go above and beyond — they work overtime, don’t take breaks, and work extra weekends.

“Even if you do all that, the quality of care never comes close to what you believe these patients are entitled to,” said Hurley. “That's why you’re seeing people walk away.”

Nursing agencies are being brought in and individuals employed with them have the convenience of working the same hours Monday to Friday and are paid “two or three times as much,” according to Hurley.

“Why would you want to stay?” Hurley asked, referring to those who are burned out and leaving for another career.

Privatization is not the direction to take, he said, as it would be 30 per cent more expensive for the province, and that especially for nursing, it would be “two or three times” more costly.

Ontario’s healthcare budget is more than $25 billion, and addressing the concerns laid out in the report would be a “tiny fraction” of the overall budget, said Allan.

In hospitals, employment has increased by 3,210 since the onset of COVID-19 three years ago in the first quarter of 2020, an increase of 1.2 per cent, or 0.4 per cent per year.

“This is a shockingly small increase considering the burden COVID and long-COVID have placed on health care. COVID aside, the need for hospital care due to population growth and aging has expanded at a much faster rate, as we shall see,” the report says.

The long-term decline in spending on hospital staff is also a major area of concern in the report.

Spending by hospitals on employee compensation has declined as a percentage of total spending, falling from 64 percent in 2005-06 to 59 percent in 2020-21 in Ontario, it says.

The Progressive Conservatives ran on a promise in 2018 of ending hospital hallway healthcare, the report adds, but “In fact, the problem has gotten worse.”

The number of inpatients being cared for in hallways has hit 1,289 per day, an all-time high, 22 per cent higher than when the government was elected in June 2018. After the hospital crisis and the cancellation of tens of thousands of surgeries with COVID, hospital bed occupancy has already returned to 93 per cent, “a dangerously high level, even as the number of surgeries has not returned to pre-COVID levels.”

Demand for staffed beds will increase further when hospitals are able to bring surgeries back to the number performed in 2019, says the report.

Both Allan and Hurley said they hope recent report will catch the attention of the provincial government.