New hospital will cost billions
If approved, ‘state-of-the-art’ facility in Waterloo Region will open in 2034-35 to serve two million residents in catchment area that extends as far north as Tobermory
A new hospital for Waterloo Region is expected to have a price tag in the billions of dollars.
The project, if approved, is a huge undertaking, akin to the construction of the Ion light rail system, which was more than 15 years in the making and cost about $1 billion in today’s dollars.
Last month, hospital officials held a town hall and provided details about their proposal to redevelop Grand River, Freeport and St. Mary’s hospitals and build a new facility of almost 1,000 beds, at a site yet to be disclosed.
“When you look at the complexity of it, when you look at the size, when you look at the number of moving parts to get it all done, I think it’s safe to say this will likely be the largest public-sector project in this region for decades,” said Ron Gagnon, president and chief executive officer of Grand River Hospital. “It’s a once-in-a-generation project.
“It will be a state-of-the-art, world-class facility supporting a community that is aspiring to be world-class,” Gagnon said at the town hall on Jan. 16.
The proposal
The new hospital will open in 203435: planning is expected to take five years, and construction will take another five years.
Today, the two hospitals have a total of 852 beds, but say 1,272 beds (420 more) are needed in the next 15 years.
The project encompasses three separate sites, jointly operated by both hospitals:
■ a new acute-care hospital of almost 1,000 beds, providing a wide array of medical services including cancer, cardiac, eye and renal programs, emergency medicine and surgeries, a full suite of medical imaging services, and neurosurgery, for which local residents now have to travel to other cities.
■ a renewed Grand River Hospital in midtown Kitchener for outpatient care, such as same-day surgeries and clinics, and non-emergency care. It will provide urgent care, outpatient surgery, outpatient medical imaging, diagnostic services, and possibly space for other community health-care providers.
■ a renewed Freeport Hospital, with about 100 more beds for a total of 350, will provide rehab, complex continuing care, longer-term mental health, outpatient rehab and medical imaging.
■ St. Mary’s current building on Queen’s Boulevard is not suitable for redevelopment. Its future use is still to be determined, but possibilities include long-term care or home care.
The redeveloped hospitals will serve a total of two million residents in a catchment area that extends as far north as Tobermory. A member from Cambridge Memorial Hospital is on the new hospital’s project planning committee, because many Cambridge residents already come to Kitchener to get regional services, such as cancer, cardiac and renal care.
The cost
Hospital officials have yet to put a definite price tag on the redevelopment, and the province has not approved any funding, other than a $5-million planning grant in April 2022.
But other hospital projects that are smaller than this one have cost billions.
The Cortellucci Vaughan Hospital, which opened in 2021 with 350 beds, cost $1.7 billion. South Niagara Hospital, set to open in 2028, will have 469 beds — about half the size
of what is wanted here — and will cost $3.6 billion to build. That project was overseen by Cliff Harvey, who is heading the Waterloo Region project, known as Building the Future of Care Together.
The planning grant is a clear signal of the government’s support for the local project, which was also mentioned in provincial budgets in 2022 and 2023, Harvey said.
When it announced the grant, the province acknowledged the growing needs of the region.
“Located in one of the fastestgrowing areas of Ontario, it’s critical that both hospitals grow to meet the needs of the communities that they serve,” said Christine Elliott, health minister at the time.
The province pays most of the cost of building a new hospital. But it’s clear the project would need a significant injection of cash from the local community, likely hundreds of millions of dollars.
“It will take the support of the community, for sure,” Gagnon acknowledged.
Ten per cent of building costs and almost all the equipment costs must be raised locally, likely through a combination of fundraising and a special hospital property tax levy. By comparison, the 469bed South Niagara Hospital is looking to generate about $300 million to $400 million locally, spread over several decades.
Waterloo Region isn’t the only community asking the province for big money for hospitals. “The reality is there are 50-plus communities in this province right now that are looking for a new facility,” Gagnon said at the town hall.
Officials say they’re confident the province will fund the project, noting it has been mentioned in the 2022 and 2023 provincial budgets and in Infrastructure Ontario’s plans.
The hospitals are “working every day with the ministry and the province” to move the project forward and to stress that it’s needed if the region is to meet provincial growth targets, said Mark Fam, CEO of St. Mary’s hospital.
The need for redevelopment
Proponents say there are several good reasons for hospital expansion.
First, this region is one of the fastest-growing urban areas in the country — growing 10.1 per cent between 2016 and 2021 — outpacing Toronto, Calgary, Vancouver, Ottawa, Hamilton and London.
Its population is also aging: the population aged 75 or older — who need hospital services the most — is expected to almost triple over the next 25 years.
The hospital buildings are also aging: some parts are more than 100 years old.
The region needs more hospital beds. It has one of the lowest numbers of acute-care beds with 1.1 beds per 1,000 people. The Ontario average is 1.4 beds per 1,000; the Canadian average is 2.0 beds.
Emergency wait times at both Grand River and St. Mary’s hospitals are above the provincial average of 2.1 hours: patients at Grand River wait three hours on average before getting an initial assessment by a doctor. At St. Mary’s they wait 2.4 hours, the latest data from Health Quality Ontario shows.
A new hospital will also allow more health services, such as neurosurgery, to be provided closer to home.
Proponents hope to bolster the local case by arguing the region is an important economic engine for Ontario and needs to have updated health care to attract new businesses and high-skill workers.
They also plan to pitch the area’s innovation and tech skills as a way for the province to get more bang for its buck. “What actually is a very big selling point getting government approval is moving the needle on health care,” Harvey said at the town hall. “There’s a great opportunity here with the universities, with the college, to actually create an innovation campus, to be a beacon for the ministry to look at other projects.”
The site
A site selection committee will recommend a site this spring. Three sites are under consideration. Selection criteria include a site of at least 50 acres (20.2 hectares) suitable for a helipad — air ambulances now have to fly in to the regional airport in Breslau; proximity to densely populated areas, roads and transit and other services, businesses and amenities; and access to nature, views and natural light.
Why such a large site? The province recommends that new hospitals be built on sites of at least 50 acres, so that buildings can expand in future without outgrowing the land they are on. The current hospitals occupy a total of 37 acres: Grand River Hospital is on 13.5 acres, Grand River’s Freeport campus is on 19.5 acres and St. Mary’s General Hospital is on four acres.
To get an idea of how big a site the hospitals want, the lands occupied by the Aud and the adjacent Kitchener Armoury equal about 48 acres.
The plan for a joint project builds on decades of collaboration between the hospitals, and increases the likelihood of success, Gagnon said. “By going our separate ways, the community wouldn’t actually get what it needs.”
There is keen interest in the community in the project: hundreds attended the first public town hall on the project, and more than 11,300 submitted comments to the site selection committee. That may be because almost everyone uses the hospital at some point — about one in every 2.5 people use the hospitals today.
Construction will bring disruption and challenges, but hospitals have lots of experience with providing ongoing services while renovations are underway, Fam said.
For more information, go to futureofcaretogether.ca, where people can sign up for updates.