ADVISORY: OHC 2016 Pre-Budget Briefing

Posted: February 25, 2016

(February 25, 2016)

2016 Pre-Budget Briefing

Where We Stand: Ontario’s Ranking in Public Service and Health Care Expenditures & Cuts

Ontario’s government is making budget choices that cut and privatize public services and health care. These are choices, not necessities. Here’s how we compare relative to other provinces and jurisdictions on some key measures.

The Notable Trends Are:

1. Ontario ranks at the bottom of the country for hospital beds per 1000 population (Chart 1).
2. Ontario ranks near the bottom of the entire OECD for hospital beds per 1000 population (Chart 2).
3. Ontario is at the bottom of the country for nurse to patient ratios (Chart 3).
4. Ontario and Quebec continue to compete for last place in hospital funding per person (Chart 4).
5. Ontario is second last in the country for public hospital funding as a percentage of provincial GDP (Chart 5).
6. Ontario is near the bottom of the country for public hospital funding as a percentage of all provincial program funding (Chart 6).
7. Ontario’s hospitals are running over capacity. In many instances bed occupancy rates exceed 100% (Chart 7).

Priority Recommendation: Stop Devastating Hospital Cuts & Restore Funding to Average of Other Provinces

Hospital global funding increases have been set below the rate of inflation since at least 2008. Since 2012/13 global hospital budget funding levels have been frozen. In sum, this means that global hospital budgets have been cut in real dollar terms (inflation-adjusted dollars) for 9 years in a row. This is the longest period of hospital cuts in Ontario’s history and there is no end in sight. The evidence shows that the hospital funding formula and austerity measures that have cut global hospital budgets in real dollar terms for almost a decade, have resulted in a dramatic reduction in needed services. By key measures, Ontario now ranks at the bottom of comparable jurisdictions in key measures of hospital care levels.

As a result, hospitals large and small in every geographic region of Ontario are cutting needed services. Hospitals are now at dangerous levels of overcrowding; staffing levels have dropped precipitously; and patients are suffering as they are forced to wait longer and drive further to access care and are discharged before they are stable.

A sampling of recent cuts:

• North Bay – 30 – 40 beds closing and 140 staff positions to be cut.
• Brockville – 17 Registered Nurses cut affecting departments across the hospital.
• London – up to 500 surgeries including hip, knee, gall bladder and others cancelled until next fiscal year due to inadequate funding of surgery budgets.
• Woodstock – hip, knee and other surgeries cancelled until next fiscal year.
• Trenton – virtually all surgeries cut and closed down along with half the remaining acute care beds.
• Minden – the hospital CEO is speculating openly about closing the Minden hospital.
• Niagara – five entire hospitals to be closed and replaced with one.
• Windsor — >45 nurses and staff positions to be cut affecting departments across the hospital.
• Kitchener-Waterloo – 68 staff positions to be cut affecting departments across the hospital.
• Midland – at risk: birthing, cafeteria, OR closure 2 days per week, ICU beds to be cut, along with beds and other services.

The Ontario Health Coalition is deeply concerned about the cuts to our province’s public hospitals and has focused on one key recommendation for the 2016 Ontario Budget:

Recommendation: The hospital cuts must be stopped immediately. Hospital funding must be restored to the average of the other provinces in Canada and funding must go to restoring and improving service levels to meet population need.

Chart 1: Ontario ranks at the bottom of the country – Hospital beds per population

Source: Canadian Institute for Health Information, Data Table: Hospital Beds Staffed and in Operation 2013-14. Population statistics from Canadian Institute for Health Information, National Health Expenditures Database 2015.

Chart 2: Ontario ranks near bottom of the entire OECD – Hospital beds per population

Source: OECD, Health Statistics 2015 at http://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_REAC

Chart 3: Ontario ranks at bottom of the country – Nurse to patient ratios

Source: Canadian Institute for Health Information, 2013.

Chart 4: Ontario and Quebec compete for last place in hospital funding

Source: Author’s calculations from CIHI, National Health Expenditures Database 2015

Chart 5: Ontario 2nd to last in the country – Public hospital spending as a percentage of provincial GDP

Source: Author’s calculations from CIHI, National Health Expenditures Database 2015

Chart 6: Ontario at bottom of the country – Public hospital funding as percentage of all provincial program funding

Source: Author’s calculations from CIHI, National Health Expenditures Database 2015

Chart 7: Ontario’s hospitals over capacity – Hospital bed occupancy rates

Chart 8: The consequences of emergency department overcrowding

OHC 2016 Pre-Budget Briefing (PDF)