Crumbling Hospital Infrastructure Threatens the Care of Canadians
Estimated at Upwards of $15 Billion to Repair
Calls for federal government infrastructure support at the National Health Leadership Conference in Charlottetown, PEI, June 15-16, 2015
CHARLOTTETOWN – The state of disrepair in many of Canada’s hospitals – with a price tag in the billions of dollars – poses a severe threat to access to and quality of care, warns a presentation being delivered today at the National Health Leadership Conference’s (NHLC) Great Canadian Healthcare Debate in Charlottetown, PEI, co-hosted by HealthCareCAN and the Canadian College of Health Leaders.
To save costs or meet budget targets, hospitals across the country have been postponing critical repairs. Preliminary results from a HealthCareCAN study shows that initial estimates of the accumulated deferred maintenance (ADM) average out at $15.4 billion, but that number could be as high as $28 billion. Based on public documents, deferred maintenance costs are estimated to be at least as high as $11.4 billion in Ontario and $600 million in Nova Scotia (over a 10 year period), at least $600 million in Saskatchewan (between 2015 and 2018 to address crumbling infrastructure needs)and at least $637 million in Alberta.
“Allowing the continued deterioration of our healthcare facilities will quickly become a health and safety issue,” says Rob MacIsaac, President & CEO, Hamilton Health Sciences in Ontario. “Moreover, the fact that many buildings are so badly worn down, inefficient and damaged is demoralizing for patients and staff, and has a direct impact on care.”
With tight budgets and slow economic growth, the problem is expected to worsen – unless new funding strategies are employed. Having the federal government kick-start these repair projects is on the agenda of the NHLC’s Great Canadian Healthcare Debate. One resolution calls on healthcare leaders to petition the federal government to include hospital infrastructure renewal and deferred maintenance as eligible expenditures in any existing or future federal infrastructure programs.
The federal government last invested deliberately in hospital infrastructure (intended for service delivery) almost 50 years ago, through the 1966 Health Resources Fund Act.
Experts suggest that hospitals have an estimated shelf life of no more than 40 years, meaning a federal injection into health infrastructure was due around 2004. That year, the Kirby Committee urged the government to put $4 billion in a health capital fund; this recommendation wasn’t followed.
“Since then, more than 1,200 scholarly articles have noted how modernized hospital facilities prevent errors, reduce infections, improve recovery, shorten length of stay, and increase efficiency,” says Bill Tholl, President and CEO, HealthCareCAN.
The minimum annual investment required to keep deferred maintenance in Canadian hospitals from growing any further is between $2.8 billion and $3.21 billion annually.
The infrastructure resolution at the Great Canadian Healthcare Debate touches on three key challenges.
One, does the federal government have a role given healthcare is principally a provincial jurisdiction?
Two, are healthcare facilities of the future in fact part of our national infrastructure?
And, three, what proportion of infrastructure fundraising should communities bear for local hospital projects?
Fixing the crumbling hospital infrastructure will ultimately accelerate the transformation of the health system to meet tomorrow’s needs, suggests Rob MacIsaac. “By repairing and retrofitting healthcare spaces,” he says, “we can accommodate new models of care, improve access to care, and accommodate more innovative technologies that help people to get home safer and faster.”
The presenters are emphatic in addressing each of these questions. They explain the federal government often uses the current health system infrastructure to meet the needs of various populations. The federal government also has a longstanding leadership role in providing health-related services such as public health, health protection programs, first nations health and health research. As the presenters note, lack of federal support for repairing or replacing hospital buildings that are past their best before date make it difficult for the federal government to:
- Play the necessary part in the country’s emergency preparedness and disaster management systems.
- Maintain standards of infection control.
- House the advanced technologies that fuel research.
- Attract and retain the best health care providers and researchers.
The federal government considers infrastructure projects to be “nationally significant” if they support one or more of these objectives: “generate positive economic activity; reduce potential economic disruptions or foregone economic activity; generate productivity gains for the Canadian economy; or provide benefits that extend beyond the provinces or territories where the project would be located.”
The New Building Canada Infrastructure Fund is limited to categories like highways, roads, bridges, public transit, rail, airports and ports. Yet healthy hospital infrastructure is not eligible despite the enormous impact on the economic health and physical health of every community.
“Building and expanding health infrastructure creates jobs and economic activity,” says Bill Tholl, “Investing in healthcare facilities of the future also promotes the healthy populations that are essential for a productive economy.”
In a new Ipsos Reid survey for HealthCareCAN, 77% of respondents say while governments talk about the need to invest in roads and bridges, investing in aging hospitals is a higher priority.
Tholl adds that it’s problematic that certain communities can raise more money, and therefore expedite construction and repairs and achieve better access. That causes inequalities in access to needed healthcare, and is not consistent with the intention of the Canada Health Act. A boost in strategic federal investments in healthcare infrastructure can help to even the playing field for communities.
Presented by HealthCareCAN and the Canadian College of Health Leaders, the National Health Leadership Conference hosts more than 700 healthcare leaders from across the country. Keynotes and presentations will focus on driving a culture, of engagement, innovation and improvement in Canada’s healthcare system. The Great Canadian Healthcare Debate is a unique forum giving health leaders the chance to pass resolutions aimed at helping policy-makers address the key healthcare challenges Canada now faces.