Unions’ report says HHS, St. Joe’s underfunded by more than $181M; study questioned

Health experts question methods, take issue with underfunding claim

Hospital unions say Hamilton Health Sciences and St. Joseph’s Healthcare are underfunded by more than $181 million.

But health experts question the methods used by the Ontario Council of Hospital Unions, which released its Hamilton report Friday.

“We do believe we’re comparing accurate numbers to accurate numbers,” said Michael Hurley, president of the council. “The reductions in acute care capacity are obvious.”

Based on Ontario’s population, per-person spending on hospitals has steadily gone down in Ontario to $1,395.73 in 2016 from a high of $1,417.31 in 2013, the council says.

In comparison, the Canadian average has gone up since 2007 to $1,605.43 in 2016. If Ontario is removed from the average, spending jumps to $1,749.69.

“That is a whopping 25.3 per cent more than Ontario,” states the report, which used data from the Canadian Institute for Health Information. “In 2005-2006, the gap was 4.3 per cent.”

However, the report is comparing apples to oranges, says health economist Livio Di Matteo, who is a professor at Lakehead University.

“It is not reasonable to compare Ontario to Nunavut or a smaller Atlantic province,” he said. “Ontario spends less per capita on hospitals but it has a much larger population and therefore part of the difference is due to the fixed costs of running a health system being spread over a larger population base.”

He says Ontario should be compared to Quebec, which spends less per capita. It could also be compared to Alberta or British Columbia, which spend more.

Health policy researcher Raisa Deber says she found the opposite of the unions.

“The total health spending in Ontario was almost identical to the rest of the country,” said Deber, professor of health policy, management and evaluation at the University of Toronto. “Hospitals were indeed less and one of the reasons was because when you change how you deliver care, you change which line item the same services go under.”

For example, eye surgery done outside of hospitals is tallied under spending on physicians.

The council looked at spending on long-term care, home care and community care and found it was also below the national average. Funding of physicians was higher.

“Downsizing is taking place in the acute-care hospitals but the investments are not materializing at all to the same extent in other parts of the health-care system,” said Hurley.

The report suggests Hamilton’s hospitals are short 577 nurses and 1,716 other workers.

“Unfortunately, this report fails to consider the many nurses, PSWs and other health-care providers who are providing care to patients in Hamilton in their homes and other settings within the community,” Health Minister Eric Hoskins said in a statement. “While we continue to invest in hospitals, patients increasingly prefer to receive their care closer to home and we’re moving toward a system that reflects this.”

The council wants Hamiltonians to contact their MPPs about hospitals getting a one per cent increase when inflation is closer to four per cent. Hamilton Health Sciences is eliminating $30 million from its $1.2-billion budget by March 31, 2017, while St. Joseph’s cuts $26 million from its $550-million budget.

In the end, the best way to measure care isn’t by the dollars spent, Deber said. “My bottom line is, ‘Are people getting the care that they need that is high quality and when they need it?’”