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Small and rural hospitals in Ontario have been “decimated by successive governments’ policies,” according to a retired Registered Nurse.

“Despite repeated assertions from various governments that they are in fact protecting small hospitals, this is not the case,” said Shirley Roebuck, R.N. in her report published in April.

“Some have closed. Some have been severely downsized to the point where most of the services that were once provided are no longer available locally. Others’ futures are yet to be known.”

In her report, Ontario’s Small and Rural Hospitals Are At Risk: How We Can Protect & Restore the Vital Role of Community Hospitals, published on April 7, Roebuck said communities have spent decades building and maintaining their local hospitals that are “seen as one of the most vital public services in the community.” 

Roebuck graduated in 1972 from the Victoria Hospital School of Nursing in London, Ontario and spent a long and varied career working in tertiary care hospitals, including Toronto General Hospital, St. Michael’s Hospital, the Wellesley Hospital and other Toronto hospitals, before moving to Southwestern Ontario and working in a small, rural hospital in Wallaceburg, Ontario.

“I have the experience and knowledge to comment on the current state of health care in this province, not only as a nurse, but as a daughter, a cousin, a friend, as well as a user of health care services,” said Robuck.

“Big city hospitals in Ontario are overcrowded, and admission wait times are longer that they should be. Small community hospitals have seen their beds cut and their services eliminated or moved to larger centres. They are a shell of what they used to be, and are able to support larger community hospitals or big city hospitals to a much lesser degree. Thus there is a back-up of care at all levels: small rural hospitals, larger community hospitals and big city hospitals.”

Roebuck said “Closing and cutting small local hospitals in an effort to decrease hospital admissions and cut beds more deeply than anywhere else in Canada means that Ontarians are not receiving the services or time in hospital that is needed to assure a successful discharge to the community.”

“Repeat visits to the Emergency Department and repeat admissions are rising. People are developing more health problems while in hospital, and patient outcomes are worse.”

“People’s health has been negatively affected by the piecemeal approach to achieving budget cuts.”

Roebuck recommended restoring “proper” hospital funding and the role of small rural hospitals in Ontario.

“They also require a coordinated and effective public home and community care system that is not simply seen as a cheaper way to offload hospital patients,” she said.

“Rural hospitals can become vibrant again, with basic hospital services being offered: in-patient beds for medicine and surgery; a full service Emergency Department; a variety of basic outpatient clinics, e.g. dietary health, pulmonary function testing, etc.; a full service laboratory and diagnostic imaging departments.”

She also suggested better integration with larger hospitals and that laboratories with registered laboratory technicians become standard in small rural hospitals.

Roebuck’s report included contributions by Dr. Ray Dawes, Fran Renoy ret’d Health Professional, Kathleen Tod, ret’d R.N. and Natalie Mehra, Executive Director of the Ontario Health Coalition.

“There are financial reasons to restore the role of small hospitals,” said Dr. Dawes, a rural physician who is the past chair of the Section of Rural Practice of the Ontario Medical Association.

“Any patient treated in a rural hospital at daily rates of $400-500 per day will save the system money compared with large hospitals at rates of $1000-2000 per day.”

Kathleen Tod, a retired nurse serving in a variety of rural and larger hospitals throughout her career, shared her thoughts on the closure of the Burk’s Falls hospital.

“The silence is heart-rending,” she said. 

“Rooms that once offered sanctuary to the sick and halls that once resounded to the echo of busy feet are now filled with overflowing boxes and sundry equipment. The venerable Burk’s Falls and District Health Centre is dead! Sixty-one years of history, care and healing is now ‘headed south.’ Literally.”

To read the full report visit the Ontario Health Coalition 

“The cost savings of closing/downsizing rural hospitals have never been proven,” said Roebuck. 

“As a nurse, I see every day how budget cuts have downloaded costs and stress onto patients and their families who struggle to travel further for care or go without, putting their health in jeopardy.”

John Bonnar

John Bonnar is an independent journalist producing print, photo, video and audio stories about social justice issues in and around Toronto.