BRIEFING NOTE: Sampling of Recent Ontario Hospital Service Closures
Posted: September 15, 2023
(September 15, 2023)
The following briefing note gives a sampling of local hospital emergency, ICU, birthing and other vital service closures across Ontario in 2023. There are many more. Dr. David Savage has been tracking Ontario emergency department closures. He found 848 emergency department closures in 2022. In 2023, up until the end of August alone there had been 498 emergency department closures.
These closures are unprecedented and are getting more common and longer, threatening the future of the most urgent services in a number of communities across the province. This spring, the emergency department at the Minden hospital was closed permanently. In July in Fort Erie’s and Port Colborne’s hospitals, the urgent care centres were closed down during the overnight hours permanently. Those urgent care centres had been created to replace their emergency departments after they had been closed down permanently. Now, the plan is to close the two urgent care centres permanently, as well as the inpatient acute care services at the Welland hospital. In Chesley, the local emergency department is currently closed for two weeks straight after repeated short term closures. In that hospital corporation, which is an amalgamation of four hospitals, three of the four hospitals have repeated emergency department closures. Similarly, three of the four hospitals in the Huron Perth Health Alliance, stretching from Stratford east toward Lake Huron, the hospitals in Seaforth, Clinton and St. Marys have had repeated emergency department closures. This trend of multiple emergency department closures across entire regions is happening across Ontario from Arnprior and Carleton Place in the east to the shores of Lake Huron in the west.
The situation has deteriorated to the point that when a local hospital emergency department is closed, residents cannot be sure whether the next town’s emergency department is also closed. There is no apparent coordination.
The service closures that we have found in this briefing note are a result of staffing shortages and also funding cuts. There is still no emergency plan from the provincial government to stop the closures, recruit back staff who have left, deal with the urgent staff retention issues and dramatically increase and speed up training to get more staff into the local hospitals. Recommendations given by the hospital unions in the last year along with a request to meet the provincial government went unanswered. Comprehensive recommendations given by the Ontario Health Coalition last winter have not been implemented. For-profit staffing agencies continue to cannibalize existing staff from local hospitals, privatizing nursing and health professionals’ services, costing hundreds of millions of dollars, and worsening regular permanent staffing shortages. At the same time as local public hospital services are being closed, cut and reduced, the provincial government is moving forward with privatizing core public hospital services including surgeries and diagnostics to for-profit clinics. The province has funded at least some hospital deficits, but there is no comprehensive emergency plan to end the chaos. The bottom line? The Ford government’s priority policy appears to be privatization of the core services and staffing of our public hospitals while nothing substantive is being done to restore stability and prevent the collapse of Ontario’s public hospitals.
Glengarry Memorial Hospital had the highest number of emergency department closures in Ontario in 2022. GMH had to close its ER department 38 times in the past year due to staffing shortages. However, it has not closed its emergency department since October, largely due to using for-profit staffing agency nurses. As a result of the high cost of staffing agencies, the hospital had to go into deficit,
The provincial government announced $3.66 million in funding this week to “enhance patient care”. However, the hospital has a projected $3.5 million budget deficit due, largely, to the need to use agency staff, so the funding will simply offset the deficit.
Chief of Staff, Dr. Barry Nathanson, reports that physician shortages are the cause, stating, “Our community needs to be prepared, unfortunately, for episodic gaps in services, and it is a new reality, at least for the time being.” In the last year there were 566 births at the hospital, an average of two per day.
The hospital cut 8 ICU and overflow beds that were supposed to be permanent and that unit was reduced to running at less than full capacity as the hospital announced the lay off of 13 nurses in March due to funding cuts. It closed its flu and cold clinic last spring also.
Almonte General Hospital’s ER Department was temporarily closed on July 7th, 2023 at 3 p.m. and resumed operation at 7 a.m. on July 8th due to a staffing shortage. It was closed again overnight for two nights July 14 and 15.
Arnprior Regional Health had to close their overnight ER on May 19th and May 29th, 2023 due to staff shortage. They reported patients could go to the next nearest emergency departments including the Almonte hospital (which itself had been closed due to staffing shortages on May 18.)
Carleton Place, ON
The emergency department at Carleton has been repeatedly closed due to staffing shortages. A quick search reveals repeated announcements as in this example: Carleton Place & District Memorial Hospital again closed its emergency department temporarily overnight Saturday, with a scheduled reopening on Sunday afternoon.
President and CEO Mary Wilson Trider said the hospital was in touch with Ontario Health “to discuss possible solutions” to the increasingly frequent closures.
Carleton Place, one of Ontario’s fastest-growing communities, operates with one physician and two nurses working on each shift. If one of them is sick, there is an impact. The hospital says it is dealing with “multiple” sick leaves.
The Chesley hospital emergency department is currently closed for two weeks straight.
This follows repeated closures all year. South Bruce Grey Health Centre reports that insufficient staffing is resulting in closures of three of the four hospitals in its amalgamated hospital corporation. The nearest hospital is 19km away in Hanover or Walkerton which is 25km away. However, the Walkerton hospital has also faced repeated closures of its emergency department, often on the same dates as the Chesley hospital emergency is closures.
See for example: The temporary emergency department closures will also impact Durham and Walkerton.
The Clinton Public Hospital has faced numerous staffing shortages that has led to the hospital being forced to close or reduce emergency department hours repeatedly.
This is a longstanding issue for the hospital, which in addition to shutting down on a Sunday in July has been running on reduced hours (8 a.m. to 6 p.m.) for the last three years.
Some other recent examples include the ER department temporarily closing on June 4th and some patients being forced to travel 20km to the nearest hospital after finding out that Clinton Public Hospital was closed after 6 p.m. on July 30th.
Durham, ON (town in Grey Bruce)
The Durham Hospital has had to reduce its emergency department hours on numerous occasions because of staffing shortages. The emergency department at the Durham Hospital was closed overnight several times from June 24 to July 31. They reported patients could go to the nearest 24-hour emergency department in Hanover, which is 20 km away.
Fort Erie, ON
The Fort Erie Urgent Care Centre has closed overnight permanently as of July 5 due to staffing shortages. The urgent care centre had been initially created to replace their emergency department after it had been closed permanently in 2009.
The emergency department at Hawkesbury and District General Hospital closed its doors from December 30, 2022 at 6 pm to January 3, 2023 at 8 am. The hospital announced the closure was due to “high volumes in the Emergency Room (ER) and to a nursing staff shortage.”
The Kemptville District Hospital reaching an agreement to “borrow” physicians from The Ottawa Hospital over a 3 month period in the summer in order to avoid closing its ER department on weekends.
This agreement was made in part due to the emergency department closures the hospital dealt with last year due to staffing shortages, highlighting the ongoing issue with staffing levels the hospital has been facing.
Hotel Dieu Hospital has been forced to permanently reduce the hours of operation in its Urgent Care Centre on weekends due to a shortage of physicians. The hospital’s normal hours see its Urgent Care Centre operate from 8 am to 8 pm.
The Kingston Health Sciences Centre has noted that emergency physician staffing levels have decreased since the beginning of the year, which has led to the reduction of the Urgent Care Centre’s hours of operation.
On January 8, the Listowel Memorial Hospital emergency department was closed between 11 am and 7 pm due to staffing shortages.
Staffing issues have been a concern in the region, which prompted the Listowel Wingham Hospital Alliance to recommend that residents confirm that other hospitals in the region are open before heading to the next nearest hospital.
The Minden hospital emergency department has been closed permanently as of June 1 due to staffing shortages. Haliburton Highlands Health Services cited the significant staffing shortages, that were “significantly exacerbated by the pandemic” and have worsened over the past year, as the reason for the permanent closure.
Mount Forest, ON
Due to staffing shortages, Louise Marshall Hospital announced its emergency department will be closed overnight on July 20 at 7 pm and reopen the next morning due to a staffing shortage. In their notice to residents, they list nearby hospitals people can go to but note that some emergency departments in the region may also be closed.
Headwaters Health Care Centre was forced to temporarily close its obstetrical unit on July 7th starting at 3:30 pm due to staffing shortages, with the unit reopening the following morning.
Port Colborne, ON
The Port Colborne Urgent Care Centre has closed overnight permanently as of July 5 due to staffing shortages. The urgent care centre had been initially created to replace their emergency department after it had been closed permanently in 2009.
Red Lake, ON
The Red Lake Clinic has closed its Saturday urgent care clinic after the province reduced the physician staffing complement. The clinic also stated that emergency room closures may become more frequent.
The clinic has dealt with staffing issues previously, as it was the first hospital to temporarily close its emergency room due to a physician shortage in 2022.
The Seaforth Hospital has dealt with numerous emergency room closures this year, as it has been closed 15 times since January, as of July 2023.
St. Marys, ON
The Stratford General Hospital closed its medicine unit to admissions until further notice following the declaration of a COVID-19 outbreak earlier this week.
The North Shore Health Network’s Thessalon site was forced to shut down its emergency department for two days during the month of May due to staffing shortages.
Wingham and District Hospital has dealt with numerous emergency department closures this year due to staffing shortages.
The President and CEO of Listowel Wingham Hospitals Alliance said that the staffing shortages have led to the emergency department closing “at least once every two weeks.”