Crushing hospital debt, lotteries for family doctors paint picture of a health system under pressure

“We couldn’t squeeze any more out of the budget and we went into deficit,” said one hospital CEO to members of Ontario’s Standing Committee on Finance and Economic Affairs.

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Published Jan 09, 2025 • Last updated Jan 10, 2025 • 5 minute read

Despite temperatures that felt like minus 20 Celsius with the wind chill, about 40 nurses and health workers rallied outside the Sheraton in downtown Ottawa as a provincial budget consultation meeting took place inside, Jan. 9, 2025. Photo by JULIE OLIVER /POSTMEDIAFrom small hospitals taking on debt to stay afloat to patients entering lotteries to find a new doctor, members of Ontario’s Standing Committee on Finance and Economic Affairs received a taste of the growing pressures on the province’s health system.

Health is the largest category of spending in Ontario’s $214.5-billion budget, but members of the committee, which travels the province in the fall and winter holding pre-budget consultations, heard that the province was not spending enough to ensure access and care for many people.

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While the committee met inside Ottawa’s downtown Sheraton Ottawa Hotel on Jan. 9, protesters affiliated with the Ottawa Health Coalition and CUPE hospital and long-term care staff rallied outside, calling for more hospital and health-care funding.

Among those making presentations to the committee was Cholly Boland, president and CEO of Winchester Hospital, south of Ottawa. He asked for some “long overdue stability” for small hospitals like Winchester’s, which account for nearly half of the hospitals in Ontario. He asked that the province increase the budgets of small hospitals by 10 per cent.

“This would give us stability for the next several years. It will help us get out of debt so we can pay our bills and stop paying hundreds of thousands of dollars in interest charges so we can use all of our funding to operate our hospitals and care for patients.”

Boland said Winchester Hospital was able to balance its budget for years by being careful with spending and taking steps such as closing 20 per cent of in-patient beds to reduce costs. “But there is a limit.”

In 2021 “the well went dry, we couldn’t squeeze any more out of the budget and we went into deficit,” he said. It has continued to post annual deficits since, wiping out its cash reserves and forcing it to borrow money.

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The hospital, whose annual budget is around $50 million, is now making debt payments on a line of credit worth around $10 million. Among other things, Boland says the hospital is unable to pay many vendors on time. “Instead of paying in 90 days, it takes us nine months. You get some suppliers who won’t do business with you.

“Our financial situation is literally risking our ability to operate as a hospital to serve all our communities and be an effective partner with city hospitals.”

Boland said he was not speaking officially for other hospitals, but knew many were in similar, or worse, positions. In fact, he said provincial officials told him other hospitals were in worse shape than Winchester.

Officials at the hospital — which has maintained among the highest patient satisfaction rates in the province — spend too much time thinking about balancing the budget and making payroll “when we are supposed to be thinking about patients,” Boland added.

The committee also heard from Martine Whissel, director of the Eastern Ottawa family health team. She described the difficulty her team had hiring staff because their salaries had not increased in five years. There have been some operational funding increases during that time, she said.

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Clinics like hers, she said, can significantly reduce pressures on hospitals, but funding needs to be increased. She said an investment of $500 million annually for five years would allow the expansion and modernization of health teams across the province to better provide people care.

She also said it would align with the goals of Dr. Jane Philpott. The former federal health minister has been appointed by the province to chair a primary-care action team with a mandate to connect every person in Ontario to primary health care in the next five years.

For people like Ottawa resident Kathy Marshall and her family, that can’t happen quickly enough. She, her husband as well as two adult children and their families all learned late last year that their long-time family doctor was closing her practice.

Marshall is 67 and her husband is 72 and takes medication that needs monitoring. She said she didn’t blame her former doctor, but the news was a shock for all of them.

Marshall and her husband found a new physician after being chosen through a lottery. Her children and grandchild are still without primary care, she said. “It was very upsetting trying to find a doctor and joining the throngs.”

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According to the Ontario College of Family Physicians, 2.5 million Ontario residents were without family physicians as of last July.

Ottawa Centre NDP MPP Joel Harden, who raised Marshall’s story during the pre-budget hearings, said looking for a doctor in Ontario right now “is really like Lotto 649.”

The committee also heard from officials at Ottawa’s Queensway Carleton Hospital pitching a new program to train anesthesiologist assistants to help keep operating rooms open.

Ottawa West Nepean NDP MPP Chandra Pasma noted that Queensway Carleton was struggling with overcrowding and inadequate bed capacity for its growing numbers of patients, many with complex needs. The hospital is looking for provincial funding to more than double the size of its emergency department, add 90 new inpatient beds and build a new urgent care clinic.

In a statement, Ministry of Health spokesperson Ema Popovic said the province had increased the health-care budget by more than 31 per cent since 2018, investing $85 billion into the system this year alone, “greater than the total health-care budget of almost every province and territory combined.”

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That includes a four-per-cent increase to hospitals for the second year in a row, $44 million to tackle emergency department wait times and $330 million in permanent for pediatric care.

“Our government will continue to work with our hospital partners and the Ontario Hospital Association to ensure all of our hospitals have the tools they need to continue delivering the high-quality care patients deserve,” Popovic said.

Ontario’s per capita health-care spending was the lowest per capita among provinces in the 2022-2023 fiscal year, according to the Financial Accountability Office.

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