HOSPITAL PARKING FEES UNAVOIDABLE

The steep price of hospital parking has become a hot-button issue since the opening of the new McGill University Health Centre Glen campus last weekend, where rates hit the full-day cost of $25 after 90 minutes.

But the complex matter is not unique to the MUHC. Hospitals across Quebec charge varying fees for parking. In Montreal, maximum rates vary from $6 at the Lachine Hospital to $18 at Centre hospitalier universitaire Sainte-Justine to $20 at the Jewish General ($25 for valet service) to $21 at the Montreal General Hospital.

Patient groups have long complained parking fees are a hidden fee for accessing universal health care. Given wait times to see a physician, patients have great difficulty getting in and out before hitting the maximum daily rates. Some patients are too frail to rely on public transit. Many simply live too far away to make taking a taxi a more affordable option. And high prices may discourage visitors, which can hurt the wellbeing of in-patients or supplement their care.

In 2011, the Canadian Medical Association Journal urged for the abolition of parking fees at hospitals, calling them “a user fee in disguise” and warning they contribute to “parking-centred health care” — when patients rush their appointments to avoid shelling out more money. Quebec’s Conseil pour la protection des malades echoed those sentiments in recent days.

There is no question the fees are a hardship for many. But who, then, should defray the cost of hospital parking? Because let’s face it: hospitals need parking lots to accommodate their staff, patients and visitors, otherwise the

Patient groups have long complained parking fees are a hidden fee for accessing universal health care.

surrounding neighbourhoods — be they of St. Mary’s or Maisonneuve-Rosemont — would be unlivable if the thousands of people a day had to park on local streets.

In Quebec, hospital administrations and the health ministry justify the charges by saying it’s the only way to finance parking. In the case of the MUHC superhospital, the 2,800-space garage cost $141 million to build. The parking fees could generate about $14 million a year to pay for it and cover the cost of maintenance.

But the high charges are harder to swallow given the lack of access to the MUHC, especially for anyone with mobility issues. A new tunnel linking the superhospital to the Vendôme métro is not wheelchair accessible. Fortunately, the new Société de transport de Montréal shuttle from Lionel-Groulx métro, where there is an elevator, will help.

Another aggravating factor is that the construction of the new MUHC garage came up at the Charbonneau Commission, where it was revealed the winning consortium was allowed to propose an eight-storey outdoor structure built on a grade and call it an underground lot to shave $25 million from its bid — even though zoning at the time didn’t allow it.

But the CMAJ editorial highlighted a broader problem. The president of the Ontario Hospital Association wrote in a letter that facilities are dependent on parking revenues and that even if they accounted for just 1 per cent of their funding, eliminating parking fees would cause a $230-million shortfall in the province’s health system.

Indeed, in present-day Quebec it would make little sense to finance parking out of strained health budgets.

So some kind of charge is unavoidable. But there should be guidelines for what rates are reasonable, programs to help defray the cost for the most vulnerable users and much more transparency in how the fees collected are used.