TORONTO - Hospitals facing a cash crunch shouldn't expect a bailout from the province even if it means laying off nurses and closing beds, Health Minister George Smitherman suggested Tuesday amid warnings that such cuts will have a profound effect on patient care.
"I don't prefer that in any circumstance,'' Smitherman said in responding to reports that two hospitals are planning to cut up to 220 jobs over three years to balance their books.
"But the alternative is to have a free-for-all where hospitals spend whatever they want and send the bill at the end of the year, and the people's health-care system can't be sustained on that basis.''
Nurses who may find themselves "displaced'' by the planned cuts at the Ajax and Pickering Hospital and Centenary Health Centre in Toronto will have many opportunities to find work elsewhere under a government plan to hire more nurses, he added.
Smitherman, who has taken a hard line in recent weeks against handouts for deficit-prone hospitals, seemed to be steeling himself for another round of demands to increase funding.
By law, Ontario hospitals are forbidden from carrying deficits, and many are racing to balance their books -- which may result in cuts to services.
But dire predictions of illegal deficits have been circulating for weeks. Last month, the Ontario Hospital Association said 75 of the province's 154 public hospitals are facing a deficit for the fiscal year that started April 1, increasing to 104 the following year.
Reports that 72 nurses may lose their jobs and 36 beds may be cut at the Rouge Valley Health System to stem the tide of red ink were seized by opposition parties as proof the Liberals are forcing hospitals to slash services to balance their budgets.
Smitherman -- who pinned the blame on Rouge Valley for badly managing its finances -- is resorting to "bully-boy tactics'' with the province's hospitals, said Progressive Conservative health critic Elizabeth Witmer.
"The reality is, George is still in charge and he's made it clear that they're to take the fall for any cuts or any firings that happen,'' she said.
But hospitals are receiving more money each year, and those who can't balance their books shouldn't expect a handout from the province, Smitherman said.
"I think the taxpayers are going to say, 'Thank goodness, for once, there's a minister of health and a government that doesn't allow hospitals to operate on a blank cheque basis and to send us a bill at the end of the year,''' he said.
"(The hospitals) have difficult work to do for sure.''
Many hospitals are still hammering out two-year "accountability'' agreements with public health officials, which were supposed to signed by April 1 but may stretch into the summer, said OHA president Tom Closson.
It's unclear how many hospitals will be forecasting deficits until those agreements are signed, he said.
But planned increases in provincial funding -- 2.4 per cent in 2008-09 and 2.1 per cent in 2009-10 -- just aren't enough for hospitals to meet rising costs, Closson said.
"Clearly, there still have to be cuts made by a number of hospitals to be able to live within the 2.4 per cent and the 2.1 per cent,'' he said.
"We're still hopeful that the ministry is going to release additional funding to cover the inflationary pressures.''
When asked whether he was concerned about the cuts at Rouge Valley, Premier Dalton McGuinty noted that health-care funding has jumped 37 per cent since the Liberals came to power in 2003.
"We've got a lot of money in the system, we have many more nurses who are out there working,'' he said. "But we'll work with the hospitals to find a way to help them balance their budgets.''
The recent Liberal budget boosted health-care spending by $2.3 billion to $40.4 billion, with $500 million earmarked over three years to hire 9,000 nurses.
But nurses warned Tuesday that any cuts to nursing staff will be bad for patients.
"We expect the government to immediately address the challenges facing Rouge Valley or any other hospital in a similar predicament,'' Mary Ferguson-Pare, president of the Registered Nurses' Association of Ontario, said in a statement.
It's ironic that a government which made so many promises about hiring nurses is now firing them, said NDP Leader Howard Hampton.
"The reality is, you've got a growing population and an aging population, which means more health-care services are needed,'' he said.
"What the McGuinty government is trying to do through the side door is cut the provision of those health-care services -- in some cases it'll be cutting nurses, in some cases it'll be cutting home care -- and try to do it and pretend it's not happening.''
