Skip to main content

Declining hospital bed capacity continues under Ford government

The massive cut in the number of hospital beds in Ontario in the 1990s is, by now, well known. Community and labour movement campaigns over the last fifteen years stopped the decline in the  number of beds, but the push for cuts is relentless.  Hospital beds per capita have continued to decline right up until the most recent data reported. Moreover, Ontario remains a low capacity outlier -- with far fewer beds per capita than other provinces.  

This chart excludes Neonatal ICU beds and bassinets. CIHI does not report data, in this case, for Quebec.
This chart excludes Neonatal ICU beds and bassinets. CIHI does not report data, in this case, for Quebec.

This Canadian Institute for Health Information (CIHI) chart (above) shows a 6.9% decline in hospital beds per capita from 2009/10 to 2018/19.  Ontario had fewer beds than any other province reported per capita.  The next lowest (Alberta) had 12.2% more beds in 2018-19.

There was even a decline in the absolute number of Ontario ICU, Obstetric, Pediatric, and Complex Continuing Care ("LTC") beds, with the latter category seeing the sharpest decline.   Acute, Rehab, and Mental Health and Addiction beds increased -- although the increase in the latter was so modest that beds per capita still declined. 


The decline continued after the election of the PC Ford government in 2018.  The most recent data reported by CIHI is for 2020-21 - the start of COVID.  Overall, the number of beds per capita in Ontario hospitals has gone down  from 226.7 in 2018/19 to 224.9 in 2020-21, a 0.8% decline in two years.  Since 2009/10, that is a 7.6% decline. 


If we had stayed at the same level as 2018/19 we’d have an extra 265 beds – a little more than one extra average-sized hospital. If Ontario had the same hospital beds per capita as 2009/10, we would have an extra 2,724 hospital beds.  That's like we are missing four very large hospitals.  

This decline is hardly consistent with Ford’s promise to end hallway healthcare.  It occured despite a rapidly aging population and hardly put Ontario in a good position to deal with COVID. 

Canada (excluding Quebec) had 20.1% more acute care beds per capita than Ontario in 2020-21.  

For all categories of beds, Canada (excluding Quebec) had 9.5% more hospital beds per capita than Ontario. 

The low number of acute care beds in Ontario is part of a long term trend.  If anything, it has gotten worse.  For acute care, Canada excluding Quebec had 17.8% more beds per capita in 2018-19 and 18.3% more in 2009-10. 


Interestingly, there is no sign in this data of the big increases in hosptal beds claimed by the Ford government.  Ontario hospital beds "staffed and in operation" as reported by CIHI in 2019-20 and 2020-21 were up only 1.5% in 2019/20 and 1.1% in 2020/21.  

Notably Statistics Canada figures indicate that hospital employment by the end of 2021 was at the same level as when the Ford government assumed power -  247,000.  It will be very interesting to see CIHI's report on bed numbers for 2021-22 when it comes out.

 


Comments

Popular posts from this blog

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data.   This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization.   Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion.  That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year.   The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million.     In total, there were 60,653 COVID hospitalizations in Ontario in 2022/3, up from 47,543 in 2021/2. 

More spending on new hospitals and new beds? Nope

Hospital funding:  There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities).    For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year.   But, this is just a notional increase from the previous announcement of future hospital capital spending.  Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more th

The hospital crisis: No capacity, no plan, no end

While Canada has achieved universal public healthcare coverage, that does not mean conservative forces have given up trying to erode that coverage and expand corporate care where it does not currently exist. The battle has become particularly intense in Ontario under the Ford Progressive Conservative government, which is implementing serious cuts to the level of care and moving to bring in for-profit mini-hospitals. Inadequate Staffing.   Less and less of hospital spending is on staff.   Employee compensation as a share of hospital expenditures has consistently shrunk in Ontario. This is not some immutable law of hospital development.  It is in stark contrast with the rest of Canada, where compensation has become a larger share and now accounts for 67.1%. Hospitals in provinces other than Ontario now have 18 percent more staff per capita than hospitals in Ontario. Overall, if Ontario had the same staffing capacity as the other provinces and territories, there would be another 33,778 full t