Manitoulin Municipal Association receive no answers on concerns raised on health worker shortage
MANITOULIN—A delegation of Manitoulin Island municipal representatives met with Ontario Health Minister Sylvia Jones at the Rural Ontario Municipal Association (ROMA) conference last week to discuss many concerns locally in terms of health care on the Island. The delegation came away with the overall feeling that although they were listened to, no solutions are coming forward from the province.
“My take on this is that they have heard the concerns we raised a million times, as this is a problem throughout Ontario,” said Gore Bay councillor Dan Osborne, one of the three MMA delegates, including Al MacNiven, Mayor of the Town of Northeastern Manitoulin and the Islands (NEMI) and Bryan Barker, mayor of Billings township. “The answers we received to our questions were very scripted.”
“There were no answers given to the concerns we raised,” said Mayor MacNiven. “The minister said that the province is looking for solutions. One of the solutions is to provide more financial help to small rural hospitals.”
“They didn’t give us very much time to make our points at the meeting,” said Mayor MacNiven. “But generally, we got the points across that representatives of the Manitoulin Health Centre had brought forward at a recent meeting of the Manitoulin Municipal Association (MMA). One of the issues is the difficulty in getting locum doctors to assist local doctors in in emergency rooms at the two Island hospitals here and they have been managing with the funding that had been put in place by the province. But this program is to expire in March and there has been no news on the funding program being extended.”
“We also talked about deficit funding and the shortage of nurses and hospitals needing to use agency nurses who receive much larger rates of pay,” said Mayor MacNiven. The minister, “told us agency nurses, are helping a lot and in the North and without these agency nurses some hospitals would not be able to operate but she didn’t mention anything on the costs involved.”
As for a deficit at MHC slated to be approximately $1 million this year, “and the lack of funding and increases for hospitals that had been raised at the MMA meeting, we didn’t have time to get to that,” said Mayor MacNiven. “Our meeting started at 8:25 am but we didn’t get the full 15 minutes we were supposed to. But I think we got the message across.”
“These are concerns across Ontario. Hospitals need increased funding,” said Mayor MacNiven. “This may be a tough thing for the province to swallow, as they are being bombarded by everyone with the same concerns, but the province needs to step up to the plate and provide support.”
“We really did not make any headway at our meeting,” stated Mayor MacNIven. He pointed out the MHC is also faced with several doctor retirements this year, and noted that Island municipalities contribute toward recruitment of new doctors. As Dr. (Maurianne) Reade said at the MMA meeting, “if funding is not extended for locums, it is going to be very difficult to keep emergency rooms open. And locums make up their schedules six months in advance, and if there is no support being provided to a small hospital by the province, they will go somewhere else. The locum funding program will run out at the end of March and there have been no answers as to if it will be continuing.”
“As far as solutions to all the concerns small hospitals have, it is important to recognize that this is not a Manitoulin Island problem. Ninety-five percent of hospitals in the North, for example, are projecting a deficit in their budget this year,” Eric Theriault, vice-president of corporate support services and chief financial officer of MHC told members of the MMA (MMA) at a meeting he, Paula Fields president and chief executive officer of the MHC and Dr. Maurianne Reade, president of professional staff, told members of the Manitoulin Municipal Association (MMA) recently.
“27 percent more in global funding is provided to southern Ontario hospitals,” said Mr. Theriault. “We want equal funding. Currently we are provided funding of one to two percent increases every year in our base funding. Meanwhile inflation is increasing at a rate of eight per cent, and we currently faced with unionized employee bumps in salary of 12 percent.”
Mr. Theriault said while large hospitals have a couple of different avenues for funding, the MHC and other northern hospitals have seen increased costs but no increase in funding. Equity is needed for the North he said, noting growth and efficiency model funding is not available in small hospitals. He said the MHC is provided one-time funding for programs during the year, but the cash (funding) doesn’t arrive until February. So, the hospital has to bear the costs. For small hospitals there is not a lot of cash on hand. So, hospitals have to go to a bank for a loan or line of credit, meanwhile theinterest increases.
There needs to be a cap on the amount agency nurses can make. “We have to pay them two and a half times more than regular staff nurses,” said Mr. Theriault. He said hospital-run programs need adequate, sustainable funding.
Ms. Fields pointed out the recent auditor general report on the state of health care in Ontario was a real eye-opener. If the province addressed the issues and recommendations raised in the report, the MHC would be good shape. “We lie in the middle of the pack as far as the burden of deficit we are facing. Some hospitals are going backrupt and can’t make their payroll. “At every meeting we have with the province, they tell us ‘don’t ruffle any feathers’. And we keep hearing some good news in a few weeks, and it doesn’t come. It is disheartening.”
Ms. Fields told the MMA. “We have been working without an accountability agreement for the past two years and how the province is going to fund us.” The two Island hospitals have 11,000 emergency department visits in a year and this is increasing. She explained that for years pre-pandemic, funding was a challenge, but the pandemic created more issues and the shortage in nursing and physician shortages is something other health care services like nursing homes and home health care are facing.
The MHC is waiting to see if it will receive funding for unionized nurse and salary increases of 12 percent that had previously been restricted by Bill 124.
“With the shortages in nurses we have had to employ travel nurses, which is triple the cost,” said Ms. Fields. “And the ministry tells us don’t think of cutting services.”
The MHC has seen an increase in mental health and addictions patients, which creates capacity issues, an increase in workplace incidents and requirements for security. “We have been lobbying the ministry for 24/7 security funding,” said Ms. Fields.
Another issue facing MHC and small hospitals is a shortage of physicians. Gore Bay has three physicians for five positions, Manitowaning two physicians for two positions, Mindemoya has 4.5 physicians for 7.5 positions, and Little Current has 7.5 physicians for 13.5 positions.
Ms. Fields told the MMA the MHC board has committed to not cut services. “We’ve sat as senior team at MHC with every department as to what would happen if cuts were made. There is nothing that we can cut that would not have a detrimental effect on our services.”
Dr. Reade said that the MHC has been successful in accessing more locums, and by having locums it is more attractive to physicians to practice locally. However, the funding for this program is slated to run out at the end of March.
“Many rural communities and hospitals in Ontario, especially in the North, are facing a shortage of physicians,” said Dr. Reade. “Certainly, small rural hospitals like those in Mindemoya and Little Current have been left behind by the province. It speaks of negligence for small hospitals in rural Northern Ontario.” She explained until last summer there had been no negotiations with the province on the doctor complement for 24 years. “There are places where populations have not changed,” said Dr. Reade. However the Island has seen population increases. “In Mindemoya and Little Current more than 15 years ago the human resources we had for ER used to be survivable (for physicians at the hospitals), but with the increases in patients this hasn’t been the case for a long time.”
Mr. MacNiven said as far as the meeting with Minister Jones “I’m glad the minister took time to meet with us. They (province) are hearing from everyone across the province on all these issues. Hopefully it will sink in and they will do something.”
