What’s another 12 beds? That’s the number of hospital beds St. Michael’s Hospital cut this month in anticipation of this week’s provincial budget, which is expected to put a lid on hospital funding.

In the face of a $24.7-billion deficit and “unsustainable” growth in health-care funding, the province has signaled that radical reforms are on the way for hospitals.

Across Ontario, hospitals are responding by trimming beds, services and staff — cuts that the Ontario Health Coalition and hospital unions warn are compromising patient care.

But Ontario Hospital Association president Tom Closson says the cuts to date have been “modest” and have not hurt patients.

Still, even he says it’s getting close to that. He will be watching the budget closely to ensure hospitals get no less than a two per cent hike on base funding of about $18 billion. Equally important, he says, is the need for a significant investment in community services to offset ongoing cuts to hospitals.

As hospitals admit fewer patients and discharge them faster, people are commonly sent home on intravenous antibiotics, oxygen, dialysis and with open wounds — things that used to keep them in hospital for weeks. The expectation is that visiting nurses and personal support workers will pick up the slack.

Problem is, the community sector has not been adequately funded to manage the increasing demands, concedes Margaret Mottershead, CEO of the Ontario Association of Community Care Access Centres.

And these demands are expected to increase significantly as the health system tries to get a handle on what’s known as the “ALC problem.” ALC refers to “alternative level of care,” something required by 5,000 patients, mostly frail, elderly people, who are now in hospital even though they don’t need to be there.

Known health-care cuts
The number of hospital beds in Ontario has fallen by 56 per cent per capita since 1990. That trend has been continuing in the run-up to the provincial budget. The Ontario Hospital Association has not yet tallied the recent cuts, but they are known to include:

• The physiotherapy clinic at Toronto East General Hospital and the after-hours, pain, audiology and cardiac rehabilitation clinics at St. Joseph’s Health Centre;

• 140 jobs and almost 50 beds at Hamilton Health Sciences, which is planning to do 1,200 fewer surgeries next fiscal year; and

• 190 nursing positions at the Ottawa Hospital, where elective surgeries have been postponed and where a reduction in operating room hours is under consideration.