A new report finds that Ontario needs five times more hospital beds than the provincial government has planned — and that the province faces a 13,800-bed shortfall by 2032.
Doug Allan, a researcher with the Canadian Union of Public Employees (CUPE), met with the press on Wednesday, Sept. 11, 2024, at Kingston City Hall to discuss a new report on Ontario’s hospital capacity crisis. According to the research report No Respite: Ontario’s Failure To Plan For Hospital Patients, produced by CUPE’s Ontario Council of Hospital Unions (OCHU/CUPE), the crisis will worsen in the coming years as government funding falls short of maintaining current service levels.
Allan explained that the Ontario hospital capacity problem had been building for decades before the election of Doug Ford’s Progressive Conservative (PC) government in 2018. “But it’s come home to roost since then. We’ve got thousands of unplanned hospital emergency room closures. We’ve got very long waits in the emergency rooms that remain open. We have an unprecedented number of patients being taken care of in hallways.”
He said the PCs’ central election promise in 2018 “was that they would end hallway health care, and instead it’s doubled… We’re close to 2,000 patients being treated in unconventional hospital spaces.” Also, Allan said, “there are long waits to get surgeries. There are also very high bed occupancy levels, which are unsafe and help drive that emergency room crisis because that’s where they back up” — in other words, a bottleneck occurs when no beds are available in the hospital to allow emergency room patients who need admission to actually be admitted.
The report, citing the latest data on hospital funding, bed capacity, staffing levels, admission times, and other metrics, shows declining service levels and warns that “the worst is yet to come.”
Allan explained that the provincial government has recently announced new health-care plans to ameliorate its image in the health care field. However, if that plan is implemented as is, he insisted, “it’s going to get worse — very much worse. We have to change the plan.”
According to the union, Ontario must increase annual hospital spending by $2 billion just to maintain current service levels. For Kingston Health Sciences Centre, that would mean $45 million in additional yearly funding, he said.
According to the report, based on the government’s plans, Ontario faces a looming hospital capacity shortfall of 13,800 beds by 2032. In Kingston, that would equate to a shortfall of about 170 staffed beds, along with a shortfall of 1,160 staff.
Accounting for multiple factors, including population aging, the report estimates that Ontario needs about 16,800 additional hospital beds by 2032. However, Health Minister Sylvia Jones has repeatedly stated that the government plans to increase capacity by just 3,000 beds, one-fifth of what is required based on OCHU/CUPE’s estimates.
On Monday, Sept. 9, 2024,The Trillium reported that a record 2,000 people are receiving treatment in hallways, storage closets, and other unconventional spaces in Ontario’s hospitals every day — a 100 per cent increase since Ford promised in 2018 to eliminate the problem within a year.
“In 2018, Ford said he would end hallway health care. In 2024, he’s joking about veterinary hospitals handling overflow,” said Michael Hurley, president of OCHU/CUPE, in a release. “It begs the question: has this government given up on the hospital crisis? What is their plan to address the suffering of people due to the state of our under-resourced hospitals?”
Ontario currently has 2.23 hospital beds per 1,000 people, which is marginally lower than the 2.25 beds it had in 2019 just prior to the COVID-19 pandemic. “The hospital capacity crisis is also compounded by a lack of new long-term care beds,” notes the report, with a 20 per cent increase in the wait list since the Ontario PCs came to power in 2018.
The latest Ontario Health data from June 2024 shows that the average wait time for hospital admission is 19 hours, up from 17.8 hours year-on-year and well over the target wait time of eight hours.
Over the last year, only about a quarter of patients admitted to hospitals via emergency rooms have been within the target time set by the government — a 75 percent failure rate, according to the report.
Unless the current provincial government plan is improved, the decline of the hospital system will intensify, according to OCHU/CUPE. The report shows Ontario has the lowest staffing levels in Canada: to match the rest of the country, the province would need about 34,000 more hospital workers. Vacancies continue to rise in the hospital sector as 22,330 jobs remain unfilled across the province. The number of vacancies has grown 17 per cent over the past year, and 534 per cent since 2015.
The unions noted that “an internal government document (which it tried to keep secret) from May this year showed a looming shortage of more than 80,000 nurses and personal support workers by 2032, with no plan to recruit or retain workers… Instead of taking requisite measures, the government has been releasing misinformation about adding staff.”
Allan explained that government officials have been saying the province has “added 30,000 nurses” in the past two years, but he pointed out that the figure simply looks at new registrants without accounting for nurses who have de-registered or stopped practising. Citing the latest College of Nurses data from August 2024, Allan said the number of practising nurses has only increased by 11,263 (63 per cent less than the government’s claim).
“The government is cherry-picking data. The most relevant metric here is the number of nurses practising in the field, and that isn’t keeping pace with patient needs. The reality is the government is doing nothing to retain staff, who are increasingly demoralized in the face of ongoing cutbacks,” Allan said.
“If we had the same level of staffing as the other provinces, we would have an extra 34,000 full-time equivalent positions on a per capita basis, including 12,000 extra support workers such as porters, ward clerks, warehouse, housekeeping, dietary aides, etc.,” he detailed. “We’re missing, 842 intensive care nursing unit workers, 2,300 operating room workers,1,900 emergency workers, and so on. The biggest category that we’re missing, not surprisingly, is a big part of the hospitals, which is nursing inpatient services; almost 15,400 of them are missing. [It’s a] huge, huge gap.”
From the report: “The Future: The official government plan to increase hospital capacity by another 3,000 beds over ten years (approximately 8.6 per cent) falls even further behind demand pressures – less than a quarter of expected demand pressures. Based on population growth and aging, we need 10,095 added beds. Based on population growth, aging and utilization, we need 16,802. We are already thousands of beds behind the capacity we had in 2005. Unless the current PC plan is improved, the decline of the hospital system will intensify.” Graphic via OCHU/CUPE report, No Respite: Ontario’s Failure To Plan For Hospital Patients.
Part of that problem is the job vacancies in Ontario hospitals, pointed out Allan.
“We had a sort of a normal level of job vacancies in 2015, but it’s just gone up, up, up, up, even when all other industries were declining in the post-COVID period. It just continues to go up,” he said.
“So, what’s driving demand and which will continue to drive demand? population growth? That’s not quite such the conundrum because population growth also drives economic growth. So, as long as the government doesn’t give away the money but uses it for health care, it more or less pays for itself — more than pays for itself — but half of Ontario’s economic growth over the next 20 years, according to the Ministry of Finance, will come from population growth; that’s the issue.”
But for the next period of history, just as in the 1950s and 60s when we had to expand the school system when the Baby Boomer children were moving through school, now we have to expand the hospital and health care system, he explained.
“And that is what is not being looked at, along with increased needs such as increasing utilization — because with new discoveries, people want their diseases treated, and that costs money, too,” said Allan.
Allan estimated for the Kingston area that we need to add 21 beds per year just for inpatient patients; that does not include outpatient services and clinics, “and we’re not going to make that under the current plan,” he said.
“The total funding that we think is needed province-wide is $2 billion… It’s a seven per cent increase that addresses inflation and the capacity issues that we’re talking about,” Allan continued.
“It sounds like a big ask,” he admitted, but, “it’s actually a smaller increase than the hospital funding increase achieved last year. Last year, they wanted to increase hospital funding by 0.5 per cent. Still, because of campaigns like this and community concerns, we actually ended up with a much bigger funding increase announced at the very end of the year… This year, it’s even worse. Incredibly, their plan is to cut 0.5 per cent.”
The researcher concluded with some optimism while maintaining an emphasis on the dire situation he sees in the report’s findings.
“We are hoping we can change it this year, just like last year, to improve the outcome and maintain the hospital capacity system,” Allan said.
“Health care has been a growing crisis due to under-capacity for decades
