Why restructure hospitals?

Between 1989 and 1995, 11,000 hospital beds were closed while hospital funding increased by over 20 per cent. Yet none of Ontario's 250 hospital sites was consolidated. This bed decrease has been likened to the closing of 30 medium-sized hospitals - a poor analogy, since hospital beds and wards, not buildings, were closed. But the empty beds ­ and in some cases, empty wards and floors ­ still needed heating, lighting and maintenance.

In April 1996, the government gave the HSRC the enormous challenge of restructuring hospitals. The goal was to improve the services they provide while eliminating duplication and unused space. Since then, hospital restructuring has created anxiety among health care professionals, hospital staff and the general public. Naturally, people are attached to the hospitals in their communities. Hospitals are where most of their children are born, where personal and family emergencies are dealt with, and where their last days are often spent.

Hospital restructuring was needed due to changes in the way health care is provided today as compared to the past. Evolution in technology and health care practices that result in better and more appropriate treatments have changed the way we use hospital services. A much smaller percentage of people needing care are hospitalized today, and those who are hospitalized spend less time there than in the past. This is the result of a shift to day surgery, out-patient and ambulatory care, advances in drug therapy, the availability of home treatments and many other factors.

As a consequence of this evolution in hospital care, new needs arose for different services ­ increased home care, community mental health and long-term care. Hospitals also needed to provide different services than in the past, including sub-acute care, more rehabilitation, as well as more specialized services including MRIs, hip and knee replacements and cardiac surgery. While the need increased for other vital services, resources were being used to maintain hospital surplus capacity. In some cases, these other needs remained unmet.