NIAGARA FALLS, Ont. - About 100 Niagara-area residents took to the streets Wednesday to show their frustration with health care in the region following C. difficile outbreaks at three hospitals.

Demonstrators held signs reading, "Hospitals in peril," "Why were we not told sooner?" and "Third World health care? You must live in Niagara."

The rally took place outside the Greater Niagara General Hospital in Niagara Falls, one of three area hospitals experiencing cases of C. difficile. The bacterial disease has been linked to the deaths of 16 patients at centres run by the Niagara Health System since late May.

Meanwhile, another hospital in southwestern Ontario declared an outbreak after seeing 11 cases in the last two months. The Ontario government said teams of experts have been working with affected hospitals to help them deal with the situation.

Critics accuse the Niagara hospital network of mishandling the outbreak, which was declared June 23 after several deaths had already occurred.

At Wednesday's rally, Ontario NDP leader Andrea Horwath called for closed emergency rooms in Fort Erie and Port Colborne to be re-opened, and for Local Health Integration Networks to be shut down.

Horwath renewed her party's call for an independent investigation into the state of health care in the region.

"The Niagara Health System is a mess and it has been for a long time," Horwath told a news conference in Toronto.

"People should have confidence in their local hospitals and they should be able to rely on those hospitals -- not only to provide them with the services they need when they need it, but to not end up being sicker as a result of having been in them."

A spokeswoman for Minister of Health and Long-Term Care Deb Matthews said the minister is concerned about the outbreak and the government is taking it very seriously.

"What is important to the minister right now is that everyone is working together to manage this outbreak," Neala Barton said.

"The people of Niagara ... want to know the region's hospitals are safe and that's why we're monitoring the situation closely and taking steps to support the hospitals."

But Horwath and other critics, including union leaders, say the C. difficile issue is just one of the many problems caused by cutbacks in hospitals across the province.

More than 40 patients with the bug were reported to be in isolation this week in the Niagara Falls, Welland and St. Catharines General hospitals.

An outbreak has also been declared at Guelph General Hospital, which is not part of the Niagara system. That hospital is reporting seven cases in May and four more in June, and says at least one patient death may have been related to a C. difficile infection.

The disease causes severe diarrhea in certain vulnerable patients as a result of taking antibiotics. Elderly patients, or those with compromised immune systems, are especially at risk.

Dr. Sue Matthews, president and CEO of the Niagara Health System, says the hospitals have taken a number of measures to prevent further spread of the bug. Steps include restricting the number of visitors to the hospitals, hiring more cleaners and bringing in two infection-control teams.

The Niagara Health System is a network of seven hospitals serving 434,000 people around Niagara Falls and St. Catharines.

Progressive Conservative critic Christine Elliott said her party had serious concerns about the state of the area's health system, noting leader Tim Hudak has been calling for a review since 2007.

"The latest with C. difficile is just another manifestation of some of the problems that we've seen," said Elliott.

"But it is very worrisome, and the fact that the minister of health is not willing to initiate a fuller investigation just speaks to a lack of leadership."

Barton said late Wednesday that Matthews has decided to do just that, after meeting with regional leaders in Niagara in the spring.

"The minister has come to the conclusion that an independent third-party evaluation of the hospitals' improvement plan -- the implemented phases of that plan -- would be valuable," she said.

Meanwhile, the province sent a team of infection control experts to the St. Catharines site last week, and while recommendations for improvement were made, the team said the hospital was on the right track, Barton said.

"Our only concern right now is just making sure the hospital can do what it needs to do to make sure that it's managing and ending the outbreaks."

Michael Hurley, president of the Ontario Council of Hospital Unions, said hospital-acquired infections kill up to 5,000 people in Ontario hospitals each year.

At least half of those deaths are preventable, he said, adding overcrowding and a reduction in cleaning staff can lead to ideal conditions for the spread of superbugs.