Hospital deficits are damaging patient care due to increased wait times, reduced staffing capacity, and a devaluing of healthcare in Ontario, says a new report from the Canadian Centre for Policy Alternatives (CCPA) commissioned by the Ontario Council of Hospital Unions.

“Wait times are a canary in the coal mine,” said Andrew Longhurst, senior researcher and political economist for the CCPA, at a media conference at the Peterborough Public Library on Thursday (May 14).

This new data shows that emergency room and admission wait times at Peterborough Regional Health Centre (PRHC) have both increased significantly over the past five years, with patients waiting up to 110 per cent longer for admission to an inpatient bed.

Report examines deficits at 136 Ontario hospitals

Failure, By Design: Ontario’s deepening hospital funding crisis, written by Longhurst, collates a unique data set of three years of fiscal data from 136 hospitals in Ontario with the intention of understanding the impact of deficits on patient care.

The 26-page report states that “the majority of hospitals had deficits over the last three years,” and said that the most significant expense for hospitals is non-physician staffing compensation. This includes nurses, administrative staff, and other medical professionals.

PRHC saw an operating deficit of $9 million in the 2024/25 fiscal year compared to their annual operating revenue of $448 million, said Longhurst.

Lakeridge Health and Campbellford Memorial Hospital also experienced funding deficits in their most recent fiscal year. The deficits were $20.6 million and $3.2 million respectively.

Longhurst said current projections from the Ontario Hospital Association suggest that 70 per cent or more of hospitals will show a deficit in the current fiscal year.

Michael Hurley, president of the Ontario Council of Hospital Unions (OCHU/CUPE) who joined Longhurst on Thursday, said the report further demonstrates that “the reality is they (hospitals) aren’t funded properly.”

Longhurst’s report breaks down its data analysis by region, demonstrating that hospitals in northern and western communities are disproportionately impacted by deficits. He further said that rural communities such as the Peterborough region are also overrepresented.

The report says that “smaller hospitals made up 61 per cent of the hospitals in deficit but made up only 49 per cent of all Ontario hospitals.” The CCPA defines a small hospital as having an annual operating budget of under $100 million.

One reason given by Longhurst for this disproportionate ratio of smaller hospitals in deficits is because they lack capital reserves and have fewer resources available.

PRHC is part of the 50 per cent of hospitals in the central east region that were in deficit in 2024/25. With an annual operating revenue of $448 million, it is considered one of the larger hospitals that represented “49 per cent of hospitals in deficit and accounted for 51 per cent of Ontario hospitals.”

Increasing ER wait times a sign hospitals are struggling to meet patient demand

A key purpose of the report is to assess how funding deficits impact the quality of care provided to patients.

“Multiple important indicators suggest that hospital funding austerity is undermining care and putting patients at risk,” the report reads.

Longhurst’s report uses emergency department wait times, inpatient wait times, and available staffed beds as measures of the quality and experience of patient care.

“Emergency rooms with long wait times and overcrowding signal that the system is really struggling to meet patient demand,” said Longhurst.

At a provincial level, the report cites data from the Canadian Institute for Health Information which shows the time patients are waiting to receive an initial assessment with a doctor increased by 67 per cent between 2020/21 to 2024/25.

Longhurst said that, at PRHC, initial assessment wait times in the emergency department for the 90th percentile rose from 2.7 hours to 6.1 hours in this same period.

This data places Peterborough as “a bit of an outlier at the high end of the province,” he added.

Hurley explained that, from a frontline perspective, emergency room overcrowding leads to poorer outcomes for patients and indicated concern about the growing prevalence of “hallway medicine.”

Longhurst and Hurley both said that patients being treated in hallways is unacceptable and lacks dignity and respect.

Another factor is the wait times for patients to transition from the emergency department to an inpatient bed and admission to the hospital. According to Longhurst, the wait times for the 90th percentile awaiting admission increased by 52 per cent provincially over a five year period.

At PRHC, 90 per cent of patients must wait 37 hours in the emergency department before they can be admitted for treatment — an increase from 22.7 hours in 2020/21.

Chronic underfunding leads to understaffing and ‘devalues’ contributions of female-led healthcare work to the economy

Inpatient admission is reliant upon available staffed beds, and as such requires the hospital to have adequate staffing levels to provide care to inpatient individuals. The CCPA reports that, in 2022, Ontario had the fewest available beds at 199 per 100,000 people, compared to the Canadian average of 217 beds per 100,000 people.

“There is widespread agreement among analysts that Ontario’s hospital sector is the most undersized in Canada relative to size of the population,” reads the report.

Longhurst highlighted the lack of beds as a factor in increased wait times and overcrowding, saying that per the Financial Accountability Office of Ontario, the number of staffed beds per 100,000 people is projected to decrease from 220 in 2024/25 to 203 in 2027/28.

For his part, Hurley said that there are approximately 200,000 people awaiting surgery, of which 75,000 have been waiting beyond the medically recommended period.

In addition to the report’s analysis of wait times and staffed bed availability, Longhurst looks to factors such as a growing population, inflation, and an aging patient population as reasons for increased costs and demands in the hospital sector.

Both Longhurst and Hurley said that chronic underfunding is an attempt to “devalue” healthcare and the work of hospital staff. The report states that this “devaluing” includes reduced funding for post-secondary education, lowering immigration targets, hospital privatization, and cuts to healthcare service spending.

The CCPA also recognizes the relationship between the devaluation of care work and misogynistic beliefs about women’s contributions to the economy. According to the report, Ontario’s finance minister Peter Bethlenfalvy recently said that “85 per cent of the spending in the budget is actually for social spending (and) about 15 per cent is for infrastructure and the economy.”

“This is a very outdated and sexist belief about what counts as Ontario’s economy,” the report states, defining the “care economy” as including employment in healthcare, social assistance, and educational services. “Work in the care economy is overwhelmingly performed by women in the public sector who pay taxes, support families, and contribute to community wellbeing.”

Hurley expressed similar sentiments, saying the lack of funding for healthcare education and training demonstrates a “bias” towards male-dominated fields such as policing.

Report calls for billions in new hospital funding and workforce strategy and capital plan

Ultimately, the report makes two recommendations to the Ontario government that intend to address chronic underfunding and ensure strong patient care.

The first is to “immediately increase funding” to hospitals to meet both the short-term needs experienced by hospitals with operating deficits and the long-term demands of the patient community.

In March 2026 the Ontario Hospital Association estimated hospitals would need an increase of $2.7 billion in 2025/26 to stabilize service, while the Financial Accountability Office of Ontario estimates $6.4 billion in new spending in for 2026/27 is required to maintain current service levels.

The Ontario government’s 2026/27 budget includes an increase of 3.5 per cent with a further 2.3 per cent increase in 2027/28. Current projections from the Ontario Hospital Association suggest that costs in the hospital sector increase by approximately six per cent annually.

The second recommendation is to “develop a provincial healthcare workforce strategy” to address challenges surrounding recruitment and retention of qualified staff.

The complete report is available at www.policyalternatives.ca.

With the closure of Peterborough’s Consumption and Treatment Site (CTS) looming, community leaders are voicing their concerns about the potential impacts on service users and the community at large.

“From a service user perspective, you are removing a very important place where they start the foundations of making change to recovery,” said Donna Rogers, executive director of Four Counties Addiction Services Team (Fourcast), in a recent interview with kawarthaNOW.

On March 16, the Ontario government announced it would end funding for seven CTS site in communities that now have a provincially funded Homelessness and Addiction Recovery Treatment (HART) Hub, including Peterborough, with a “90-day wind-down period … to give clients time to transition to the support provided by their local HART Hub.”

Closure a result of provincial policy shift away from supervised consumption and harm reduction to treatment and recovery

The decision to close Peterborough’s CTS comes almost two years after the Ontario government’s August 2024 “safer communities” announcement of a policy shift to restrict harm reduction sites and make addiction treatment a priority, banning supervised drug consumption sites within 200 metres of schools and child care centres.

The announcement resulted in the closure of nine provincially funded CTS sites, including four in Toronto as well as sites in Guelph, Hamilton, Thunder Bay, Ottawa, and Kitchener-Waterloo.

At the same time, the provincial government announced a $378 million investment, later increased to almost $500 million, for new HART Hubs focused on treatment, recovery, and housing, and issued a province-wide call for proposals, encouraging the nine closed CTS sites to submit proposals to transition to HART Hubs.

In January 2025, the province announced the nine closed drug injection sites would be transitioned to HART Hubs and also announced additional HART Hubs would be created, including one in Peterborough, ultimately resulting in 28 across Ontario.

A response to the opioid crisis, the Peterborough CTS opened in June 2022 in the former bus terminal at 220 Simcoe Street in downtown Peterborough to provide a safe and medically supported space for people to consume pre-obtained drugs under the supervision of health professionals.

People using the CTS are provided with sterile injection supplies, education on safer consumption practices, drug checking, basic medical services, and referrals to addiction treatment services, housing, and other social services.

Rogers explained that such sites were funded to provide the singular function of offering a safe space and clean supplies for the use of personal illicit drugs.

“We weren’t a drop-in spot, you couldn’t loiter around, and you couldn’t have tents,” she said.

Lack of supervised consumption expected to increase emergency calls and public drug use

Following the closure of the first nine CTS sites, the Canadian Drug Policy Coalition tracked calls made to emergency services and visits to the emergency department for opioid-related overdoses.

A release from the Coalition says “Ontario-wide data shows a sharp increase in EMS calls (+69.5%) and emergency department use (+67%).”

Rogers said this data is worrying and representative of the importance of supervised consumption in the healthcare and recovery continuum. For her, it is clear people will continue to need the services provided at the CTS, but the closure will leave them with nowhere to go.

“These uses will happen somewhere else,” said Rogers of the approximate 300 uses per month supervised at the Peterborough CTS.

Furthermore, Fourcast works in partnership with paramedic and emergency medical services to function as an alternate drop-off location for individuals experiencing drug-related medical complications — a service that will also no longer be available when the CTS is closed.

The Ontario government cited concerns about public safety around CTS locations as a primary reason for the closures. However, for Rogers, the real concerns around safety will come after the CTS is closed and a gap in services has been created.

In particular, she said that when the Peterborough CTS is closed, even temporarily, the immediate surrounding area feels the impact.

“If we closed for an hour or two we would notify the library,” said Rogers, referring to the main branch of the Peterborough Public Library, which is located half a block south of the CTS.

Prior to the opening of the CTS, drug-related emergencies were a common occurrence in and around the library. In a report presented to the library board on May 12, library director and CEO Melissa Reddenit noted the library is preparing for the closure of the CTS with several steps related to safety and security.

Rogers also foresees the closure impacting police response and public works as people continue to use, although now in public spaces.

Further, Rogers said a major impact of the CTS closures will be increased costs for municipal policing and public services “downloaded” from the province.

“This is going to be a costly decision on the city,” said Rogers.

HART Hubs do not offer safer supply, supervised drug consumption, or needle exchange programs

Following the closure of the CTS, Fourcast will begin the operation of Peterborough’s provincially funded HART Hub. Peterborough is one of 28 communities approved for HART Hub funding, having secured $6.3 million through a joint proposal between Fourcast and the City of Peterborough.

In its March 16 announcement of the latest CTS closures, the province stated the goal of HART Hubs was to “fund treatment and lasting recovery from addiction, rather than continued public funding of drug injection sites.”

“It’s a philosophical shift — it’s doing diametrically different things,” said Rogers of the HART Hub system.

Like all HART Hubs, the Peterborough hub will not offer safer supply, supervised drug consumption, or needle exchange programs. Eligible activities under HART Hub funding include, but are not limited to, primary care, mental health and addictions services, supportive housing, case management, and drop-in services.

“The HART Hubs are all different,” explained Rogers.

Rogers told kawarthaNOW he Peterborough HART Hub will focus its efforts on providing healthcare and housing supports to residents at the modular bridge housing community on Wolfe Street.

Owned and funded by the City of Peterborough and operated in partnership with the Elizabeth Fry Society of Peterborough (EFry), it consists of 50 modular housing units with 24/7 onsite support for individuals with complex needs that cannot be met at low-barrier overnight shelters.

“The people on Wolfe Street can’t stay at the shelter because they have service restrictions,” said Rogers.

Focus of Peterborough’s HART Hub will be healthcare and traditional and supportive housing

When assessing how to use the $6.3 million investment for Peterborough’s HART Hub, Fourcast and community partners established that their focus should be to establish “long term stable housing, with the appropriate supports, for the people who are the most complex in our community.”

Rogers explained that individuals experiencing chronic homelessness are more likely to have complex physical and mental health needs due to a lack of access to healthcare, ultimately making finding and maintaining housing an ongoing challenge.

“They are some of the most complex healthcare patients you could ever imagine,” said Rogers.

To address the barriers faced by Wolfe Street residents, the Peterborough HART Hub will develop a healthcare team to work in partnership with the existing EFry frontline staff.

In addition to the onsite health team, the HART Hub will operate 50 units of transitional housing for residents moving out of Wolfe Street housing, a further six spaces in supportive housing hosted by the Canadian Mental Health Association – Haliburton, Kawartha, Pine Ridge (CMHA HKPR) for individuals with acquired brain injuries or a dual diagnosis including developmental disorders, and finally, a six-month “sober living” program for people who are unhoused when entering addictions treatment.

Fourcast is also working in collaboration with One City Peterborough to use newly built, single-occupant additional rental units (ARUs) as transitional housing units for individuals with complex needs requiring ongoing support.

Recognizing that other municipalities have elected to develop drop-in programs and homelessness response hubs, Rogers said the existence of the Trinity Community Centre operated by One City has allowed Fourcast to take a more targeted approach.

“We already have a homelessness response hub,” said Rogers. “This allowed us to take a laser focus on housing and housing stability.”

Despite optimism about the positive impact of the HART Hub, Rogers said it should not be seen as a replacement for the services provided by the CTS.

“There’s a discussion that it’s a direct trade off, but it certainly is not,” she said.