Randall Denley: Ford needs a rational plan to fix hospital overcrowding
- Ontario’s Ford government claims emergency room wait times are short and hospital funding generous, citing a 50% funding increase since 2018 and recent additional hospital beds.
- Healthcare professionals and public surveys report severe overcrowding, long wait times, and underfunding, with hospitals burning through $2 billion in working capital and receiving significantly less funding than requested.
- Ontario hospitals operate at about 95% capacity, exceeding the safe benchmark of 85%, with fewer hospital beds per capita compared to the Canadian average, contributing to emergency room congestion and “hallway medicine.”
- The government’s focus on cost-cutting and slow hospital bed expansion contrasts with the province’s growing demand, lacking a clear, accountable plan for hospital capacity similar to its primary care expansion strategy.
When it comes to Ontario’s hospitals, the Doug Ford government is living in a parallel universe. According to the government, emergency room wait times are short, an average of just 1.9 hours to see a doctor. Low-urgency patients leave the hospital in 3.1 hours. Hospital funding is generous. Just this fiscal year alone, hospital spending went up by $1.1 billion, an increase of nearly four per cent. Hospital spending has gone up over 50 per cent since 2018.
Hospitals, emergency room doctors, health care unions, and the public have a sharply contrasting view. Last spring, the Ontario Medical Association polled 15 per cent of the province’s emergency room doctors and found that 74 per cent cited overcrowding that was either severe or critical, preventing them from providing timely care on most of their shifts.
An Ipsos survey earlier this year found that 56 per cent of Ontarians polled thought the government had done a poor job of fixing overcrowding and wait times in emergency rooms. Only 17 per cent thought the government had done a good job. Asked if they would feel confident in getting timely emergency care, only 30 per cent said yes.
A report earlier this week by the Canadian Union of Public Employees said underfunding has caused hospitals to burn through $2 billion in working capital since 2020, forcing them to borrow to make ends meet. The Ontario Hospital Association (OHA) asked the government for $2.8 billion this year to deal with those structural, inflation-driven shortfalls. It received $1.7 billion less than it sought.
Unfortunately for the Ford government, facts do little to support the argument that hospital funding is generous or even adequate. Yes, more money is being spent and new hospital beds are being added, but what’s lacking is a convincing plan to alleviate the long-standing chronic overcrowding in Ontario’s hospitals.
The province’s hospitals typically operate around 95 per cent capacity, the government says. The generally accepted benchmark for safe acute-care hospital operations is 85 per cent. It’s that lack of capacity that makes it difficult to move patients out of emergency and into a hospital bed. That backs up the ERs and leads to the hallway medicine Ford promised to end eight years ago.
That congestion is not particularly surprising. Ontario has the lowest per capita spending on hospitals of all Canadian provinces, according to a 2025 report by the province’s Financial Accountability Office (FAO). The same report found the number of hospital beds In Ontario was 230 per 100,000 population while the national average is 249 beds.
Despite that, the OHA says Ontario has an efficient hospital system with the second-lowest provincial hospitalization rate, the lowest length of stay in acute care and the lowest inpatient cost.
The obvious conclusion is that Ontario hospitals are efficient, but the sector is too small. The Ford government sees it differently. It is conducting a three-year efficiency campaign aimed at eliminating hospitals’ structural deficits. That has meant cutting hundreds of jobs, including 400 at The Ottawa Hospital alone. The Ontario Nurses’ Association says that 1,420 nursing jobs have been lost province-wide since the start of 2025.
How can that possibly make sense in a province that already lacks hospital capacity?
What’s needed is a rational plan to increase hospital capacity to deliver the 85 per cent occupancy benchmark. Out-of-context bed increases create the impression of action but give no sense if the additions will meet need.
The Ford government says it has added 3,500 hospital beds since it was elected and will create 3,000 more over the next decade. If so, the future rate of expansion will be slower than in the past, even though the population is growing, aging and hospitals are already overcrowded.
It’s difficult to square the provincial numbers with those of the FAO. It says there were 34,700 hospital beds in Ontario in 2019-20, the first full fiscal year of the Ford government. It also says there were 35,540 hospital beds in 2024-25. Scant progress, if so.
The 3,000-bed promise was first made in 2019 and money has been added to the plan a few times since, but it remains as a goal of 3,000 beds over a decade, as if time has stood still. That’s not how you build public confidence.
If the Ford government wants the template for how to do that, it need look no farther than its own policy on expanding the supply of primary care. In that case, the government set a clear target for increasing attachment to a primary-care provider, a timeline and a cost. The government reports regularly on progress.
Hospitals desperately require the same rational approach.
National Post
Randall Denley is an Ottawa journalist and author. Contact him at randalldenley1@gmail.com