Costs of a Cure for Brampton's Hospital Capacity Crisis

 

Diagnosis: Code Gridlock. That's what the data shows for hospital space in Brampton.

Now, the province and health care system in Brampton are being called on to provide a cure for what ails the system.

According to a letter sent by one Brampton patient in April to Premier Kathleen Wynne, the number of funded beds at Brampton Civic Hospital is about half of the provincial average of 2.3 beds per 1,000 people.

To meet that average, Brampton, with a population of 523,900 would need 1,205 beds. Currently, there are 608.

That average is already lower than anywhere else in Canada, according to a health-care advocacy group, Ontario Health Coalition (OHC). In a recent report, the OHC lauded other aspects of the newest budget, but said the two-to-three per cent increase in hospital funding won't meet a five per cent increase which advocates and hospital leadership say is needed to maintain existing services. The planned $451 million investment in Peel Memorial Centre won't cover the cost of new beds.

Brampton Civic Hospital has reached Code Gridlock before. Part of the reason for the opening of the Peel Memorial Centre was to "complement the services at Brampton Civic Hospital."

The limited number of beds is not a new problem. In 2001, one consultant estimated the cost of a new 716-bed hospital at $381-million. By 2004 - after the province embraced public-private partnerships, or P3s - that estimate jumped to $525-million for a smaller, 608-bed hospital. The discrepancy was not explained. Brampton Civic Hospital opened with 479 beds operating in October, 2007.

A year later, the Auditor General's 2008 Annual Report questioned an estimate of cost overruns which was nearly $70 million higher than he expected. He also questioned whether the P3 approach was cheaper.

"Our work indicated that the all-in cost could well have been lower if the government had built the hospital itself," then-Auditor General Jim McCarter said.

The William Osler Health System Foundation manages funds for the new Peel Memorial Hospital, as well as Brampton Civic Hospital and Etobicoke General, affecting hospital care for over 1.3 million people.

According to the foundation's website, "[Peel Memorial's] Urgent Care Centre will care for more than 42,000 patients each year, improving access to emergency care at Brampton Civic Hospital."

A CTV News report this week said Brampton Civic Hospital's emergency department sees 400 patients a day, which is 160 per cent above capacity. Dr. Naveed Mohammed, VP of Medical Affairs for the William Osler Health Care System, said in that report a long-term solution would require six- to eight-hundred more beds, almost equal to another hospital the size of Brampton Civic.

While Peel Memorial could reduce some of the strain on Brampton Civic, Jamie Fletcher, a registered nurse who has worked in hospitals throughout Ontario including in Brampton, says it's not just a matter of adding more hospitals.

Peel Memorial is aiming to reduce the strain on current resources in other ways, such as by offering more outpatient procedures in day surgery to allow patients to return home for recovery, as well as more preventative care.

Fletcher says, in her experience, chronic patients in beds for extended periods add to the strain on a system already suffering from lack of capacity.

As a former candidate in a federal nomination race to represent Mississauga-Erin Mills, Fletcher says federal transfer payments are a key factor in Ontario’s ability to increase health care spending.

The provinces held out on a new health care deal with the federal government out of concern over reduced transfer payments. While health care costs have climbed by less than the rate of inflation in Canada since 2011, Ontario and other provinces argued that reducing transfer payments would strain the health care system as the population ages. In the newest deal, the six per cent annual increase of the Canada Health Transfer (CHT) was reduced to either three per cent annually or a three-year average of nominal GDP growth, whichever is higher.

Under the previous transfer payment arrangement, hospital operating funding increased more than 58 per cent, from $11.3 billion in 2003-2004 to $18 billion in 2017-2018.

The province is moving ahead with funding to address the hospital capacity issue: in an announcement at Trillium Health Partners in Mississauga this month, Premier Wynne and Health Minister Eric Hoskins announced funds for new hospital projects, bringing total provincial funding for Ontario's hospital infrastructure to more than $20 billion over the next 10 years.

"These new investments will allow hospitals to renovate existing facilities and build new ones, addressing a growing demand for health care services and a need for innovative models of care," says a press release from the Premier's office. "Essential improvements and expansions would include emergency rooms, surgical facilities and patient spaces across the province."

There are 141 hospitals in Ontario and about 34 major hospital projects are under construction or in planning.

Hospital construction is part of the province's health care action plan, Patients First.

A spokesperson for Ontario’s Ministry of Health and Long-Term Care did not answer a request for comment by deadline.

 

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