As the ongoing healthcare crisis continues in Ontario, hospitals are grappling with backlogged procedures.
Hospitals in Ontario are publicly funded, with roughly 85 to 90 per cent of all funds coming from both the federal and the provincial governments. Funds distributed by the federal government are decentralized to and administered by the provincial government. The provincial government also supplies some funding for health expenses.
The provincial government determines healthcare funding models, organization structures, and spending priorities. Governments may provide additional funding when it identifies special objective healthcare needs, as it did for the COVID-19 pandemic.
Approximately 68 per cent of funding goes to paying staff salaries, while leftover funds pays for medical supply expenses.
Hospitals are responsible for fundraising when faced with additional expenses—including capital equipment such as MRI machines, which often provide life-saving care.
According to Dr. Renate Ilse, chief operating officer (COO) at Kingston Health Sciences Centre (KHSC), most hospitals have permanent fundraising staff on reserve to raise money for capital equipment and other costs not covered by public funds.
Hospital boards consist of community stakeholders who advocate for community needs to be met in local healthcare centres. The intention of the board is to provide oversight for the hospitals and ensure community needs are met in good faith.
“It’s important to remember that boards are there to advocate in aggregate not to advocate individually,” Ilse said. “Once you sign on as a board member, your fiduciary duty or obligation as a board member is to serve the best interests of the community and the hospital to collectively as opposed to representing any particular interest group or population within the community.”
The KHSC Board consists of business members, stakeholders from Queen’s University, and members of the community.
According to Ilse, hospitals strained by demand for increasingly complex patient care, and an aging population. She noted a lack in human resources at KHSC to be one of the biggest challenges to providing patient care.
“Up until about the middle of the pandemic we had enough staff now we just don’t,” she said. “We’re doing all we can to try to retain the staff, we have to keep employees engaged. To provide them with a positive work experience.”
Ontario hospitals face additional financial strain after Ontario hospital nurses were awarded additional pay after the Bill 124—a bill that prohibited public sector workers from receiving more than a one per cent raise each year—was struck down.
At KHSC, the reopening of past nursing contracts is expected to cost millions. Despite this, the impact of the strain is unclear while KHSC waits on government plans on how to address the bill.
“We’re not allowed to run a deficit, so we’re going to have to figure out a way to balance [the budget],” she said.
“Every other hospital in the province practically, is in the same boat.”
With the recent implementation of the Ontario Health Reform Bill, some hospitals will look to offload some procedures to private clinics.
Passed earlier this month, the Ontario Health Reform Bill expands private clinics’ ability to perform publicly funded procedures.
While public hospitals receive most of their funding through direct transfers from the federal and provincial governments, while managed by the hospital board, doctors handling their own practices receive similar funds while specializing in their specific practices.
Ilse mentioned this new bill will ease the burden on KHSC.
“They would have the opportunity to ramp up activity much faster than we could at Kingston Health Sciences Centre,” she said. “We are full all the time, most of our services run at capacity.”
“They are much more nimble, and flexible than some hospitals can be,” she added.
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