PC plan a threat to small town Ontario?

The Progressive Conservatives (PCs) plan to turn health care funding responsibilities over to 30 to 40 hospitals. These "hub" hospitals would be licensed to move money from one provider in the area to another.

This will leave the other 120 or so hospitals beholden to the hub hospitals for funding.  With funding pressures to the fore, centralization of services is becoming a bigger trend, leaving hospitals in smaller communities especially vulnerable in this funding model.

Douglas Memorial Hospital, Fort Erie
In the last round of PC sponsored restructuring, hospitals in smaller towns and cities were closed and others were merged into multi-site hospital corporations (e.g. the hospitals in the Niagara region).  In the following years, the small hospitals that were merged often lost services to the bigger cities in their multi-site hospital, creating special outrage in Fort Erie, Port Colborne (both in Niagara) Shelburne, and Muskoka, as hospitals in those towns were closed or stripped bare.

Yesterday, the president of the Niagara South Medical Society said he believes program consolidations to the new St. Catharines hospital facility will have a devastating impact on two other smaller Niagara region hospitals serving Niagara Falls and Welland.

“We will be left with a carcass of a hospital which will become a chronic care facility.”

The same centralizing forces are likely to be at play when 30-40 larger hospitals get to determine where services are placed. Indeed the trend will likely be much more so now, as the PC will almost certainly squeeze hospital budgets hard for years to come (just as the Liberals plan to do).

So what towns are at risk of being placed on the second tier?  Under the PC plan, the average hospital hub would look after 330,000-440,000 people.  Given that hospital hubs in larger communities may cover more people and that smaller cities can cover people in the surrounding area, towns with over 100,000 people (e.g. Kingston, Guelph, Sudbury, Thunder Bay) may be safe.  But other smaller communities are at risk.  Here's my list of communities with hospitals at risk:

  • St. Thomas
  • Stratford
  • Belleville
  • Brockville
  • Hawkesbury
  • Pembroke
  • Cornwall
  • North Bay
  • Coburg / Port Hope
  • Collingwood
  • Owen Sound
  • Orillia
  • Smith Falls / Perth
  • Napanee
  • Carleton Place
  • Kemptville
  • Timmins
  • Espanola
  • Dryden
  • Fort Frances
  • Rainy River
  • Woodstock
  • Almonte / Lanark
  • Blind River
  • Wawa
  • Thessalon
  • Kirkland Lake
  • New Liskeard
  • Mattawa
  • Sturgeon Falls
  • Parry Sound
  • Clinton
  • Barry's Bay
  • Winchester
  • Alexandria
  • Owen Sound
  • Wiarton
  • Walkerton
  • Wallaceburg
  • Newbury
  • Strathroy
  • Hanover
  • Ingersol
  • Tilsonburg
  • Huntsville
  • Cambridge
  • Grimsby
  • Lindsay
  • Elliot Lake
  • Alliston
  • Sioux Lookout
  • Orangeville
  • Campbellford
  • Haliburton
  • Midland / Penetang
  • Atikokan
  • Red Lake
  • Geraldton
  • Iroquois Falls
  • Hearst
  • Cochrane
  • Sensenbrenner
  • Smooth Rock
  • Chapleau
  • Chatham-Kent
  • Sarnia
  • Leamington
There's more, but I think the point is clear.  It's especially odd as the PC base is in smaller, rural communities.

This list doesn't include rural hospitals already included in multi-site corporations centred around a large city  (e.g. Niagara Health Sciences, Lakeridge) as they are already in trouble.  It also doesn't include community hospitals in large urban areas that may lose out on hub status to another hospital in a neighboring community.

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