As Hamilton hospitals cut $42 million, overcrowding expected to get worse

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Hamilton's hospitals must cut costs by $42 million this fiscal year while they continue to struggle with significant overcrowding that has left them with more patients than funded beds.

"We are in a crisis when it comes to our hospitals already," NDP Leader and Hamilton Centre MPP Andrea Horwath said Friday.

"It's just horrifying we see these levels of cuts on the horizon."

Ontario's hospitals have endured eight years of budget freezes or increases well below inflation that require them to cut costs every year. HHS has axed the budget by $200 million since 2011 and St. Joseph's by $94 million.

"It's obvious that the hundreds of millions that have already been cut have created hallway medicine in our hospitals," said Horwath.

"Ultimately, things are going to get worse and not better."

This fiscal year is no different with the province providing $384 million to hospitals across the province, which is well below the $656 million the Ontario Hospital Association said would be needed to avoid further cuts.

As a result, HHS has to shave $30 million out of its $1.3-billion budget for the fiscal year that started April 1. St. Joseph's must find $12 million in savings on its roughly $550-million budget.

Both hospitals refused The Spectator's repeated requests for interviews to explain how they will balance their budgets by March 31 and what they will cut.

 

However, HHS acknowledged it will affect jobs in a statement Friday by chief financial officer Dave McCaig.

"It is becoming progressively more difficult to manage these ongoing and rising cost pressures due to inflation and increasing patient volumes," McCaig said.

"In an organization where 70 per cent of our costs are for salaries and wages, having an impact on jobs is unavoidable."

He said HHS will first eliminate vacant positions, accommodate early retirements and voluntary exits. It will also look to reassignments and retraining.

The Canadian Union of Public Employees Local 7800 has also been kept in the dark about the details of what is being cut, with president Dave Murphy saying, "It has been silent."

St. Joseph's warned its staff about the shortfall in an email Friday from president Melissa Farrell that said the cuts will require "balancing the need to ensure little to no impact on patient care, quality and outcomes."

But there were few concrete details of how St. Joseph's will do that.

Instead, the email referenced vague strategies such as looking for alternate revenue sources, advocating the province for more funding for unnamed programs, delaying planned spending and finding more cost savings.

Farrell also said in the email that St. Joseph's plans to work with community providers to get out of hospital patients who should be cared for elsewhere.

Blocked beds are a major issue for Ontario hospitals with around 15 per cent of the 1,250 adult acute care beds at HHS taken up by patients who can't leave because they are waiting for home care, long-term care or other types of community care.

At St. Joseph's, one in four of its 796 beds were taken in August by patients who no longer needed to be there but had nowhere else to go.

It means more than 300 of Hamilton's hospital beds — the equivalent of a medium-sized hospital — are unavailable at any one time.

It contributes to backups throughout the hospital that has left HHS with an occupancy rate over 100 per cent continuously since August 2016. St. Joseph's hasn't been below 100 per cent in a year.

Hospitals can't turn patients away because they are full so the result is what is known as hallway medicine when beds that aren't paid for by the province are opened up — sometimes in unconventional spaces such as hallways, sunrooms and family rooms.

The hospitals have to fund this out of their budgets, which is especially difficult while cost-cutting.

The province has vowed to fix hallway medicine partly by expanding home care and long-term care.

"The ministry is committed to an efficient, stable hospital system that ensures patients receive timely access to quality health care and is making necessary improvements to deliver on that commitment," ministry spokesperson Dave Jensen said in a statement.

"The ministry is aware of capacity pressures in Hamilton and continues to work with the local LHIN to create additional capacity and support the growing demand for hospital services."

Over the next five years, 952 new long-term care beds will be built in the Hamilton Niagara Haldimand Brant Local Health Integration Network, which includes Burlington.

An additional 800 existing beds will be upgraded to modern design.

On Sept. 10, the province announced the expanded beds will include building a new long-term care home in Hamilton called Shalom Manor.

The province also gave out $155 million in funding provincewide Friday to expand home care and transitional care — with about $5 million of that going to Hamilton.