Health strains on horizon yield ‘call to action’: Sault Area Hospital

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Sault Area Hospital’s modus operandi remains maintaining current services. 

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However, the most recent operating plan, unlike the previous year’s roadmap, gazes more deeply into the horizon. 

The region’s principal health-care facility presented to its board in 2024 an operating plan that maintained existing services, anticipated additional needs for hospital services due to lack of primary care access and resulted in a deficit of up to $30 million. 

“We were faced with considerable uncertainty as a hospital, considerable uncertainty in the health system,” SAH president and CEO Ila Watson told directors and senior staff Monday. “(Maintaining the status quo) may seem like an obvious thing, or even a low bar, but in the face of considerably uncertainly, it was a significant ask. 

“It was founded on the belief that our community needs all of what we’re currently doing.” 

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The fiscal picture changed when SAH received Bill 124 compensation funding for the first six months of the year, which whittled the forecasted deficit down to$23 million.

Bill 124, ushered in by the province in 2019, capped wages on public-sector employees, including many health-care workers. It restricted wage increases to a maximum of one per cent for three years and effectively limited the bargaining process for unionized employees. However, the bill was overturned in 2023.

More Bill 124 compensation came in October, along with other funding, which sliced the forecasted shortfall to $14 million. More provincial dollars in December and March finally left the facility with a forecasted deficit of $2 to $2.5 million. 

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“A considerable change,” Watson said. “I think it highlights that it was a reasonable risk to take.” 

Skinny on 2025-26 operating plan

Assumptions around the approved 2025-26 operating plan include no reduction in services, revenue/funding increases beginning in Fiscal 2026/27, an average annual compensation increase of four per cent, assuming step increases and cost of living adjustments, inflation of three per cent in Fiscal 2026/27 and Fiscal 2027/28 and two per cent thereafter, and that wage arbitration award funding and 2.8-per-cent base funding are received. 

SAH anticipates a $12.4-deficit if it receives 2025/26 wage arbitration costs and the 2.8-per-cent base-funding boost. 

“We’re still concerned about the gap,” Watson said. “Because we started in such a significant number last year and ended up quite smaller, it’s worth considering some of the things that might change our financial position.” 

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A return to surplus position will not be possible without “significant” Ministry of Health funding and/or reduction in services, which, SAH says, would impact quality of care. 

“(The projected deficit), of course, is concerning,” Watson said. “But also, we have considered the focus of continued operations and beginning to build some future focused enhancements to continue to be able to meet the population’s health needs.” 

Which, SAH says, could become profound. 

Trouble on horizon

The hospital cited a University of Toronto study that forecasts “unprecedented” strain on Ontario health care. In fact, research says some 3.1 million people are expected to be living with major illness in 2040, up from 1.8 million in 2020. And about one in four adults over 30 will be living with a major illness in 2040, requiring significant hospital care, up from approximately one in eight individuals in 2002. 

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“If this isn’t a call to action around health-system planning and evolution, I’m not sure what is,” Watson said. 

SAH says Ontario health care has reached a “critical” turning point with high-cost pressures, a rapidly growing and aging population and increasingly complex needs.  

“We’re seeing that sort of scenario present to us here, for sure, with other hospitals and other parts of the health system,” Watson said. 

However, there has never been a time of greater opportunity for Ontario health care given its “dedication, talent, ingenuity and potential,” SAH said, adding the health system is a “tremendous asset.”

Hospitals remain “committed” partners with government and health-sector stakeholders and are determined to work toward a renewed cross-sectoral approach to building a strong health system in Ontario, SAH says.

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No going it alone

Watson said Sault Area Hospital is “committed” to being part of a system that supports “significant” health-care advancements over the next five years, with a focus on helping individuals achieve higher levels of wellness while “enhancing their experience” during treatment. 

The plan includes enhancing the hospital’s “model of care” as well as enriching digital health strategies.  

“We know there are many technology opportunities, some we are utilizing now and see lots of opportunity to grow with digital enablement,” Watson said. 

SAH also aims to strengthen partnerships with NOSM University for research, learning and physician recruitment, as well as collaborate with the Algoma Ontario Health Team and community agencies to establish a post-acute and restorative care site.  

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“We know that it is an important aspect of a practice life for health-care professionals. They want to participate in learning,” Watson said. 

SAH will also support the development of a Geriatric Centre of Excellence to improve senior care, as well as work with community partners on education and wellness campaigns for preventative care. There will be a focus on Indigenous health, leadership development, workforce planning and recruitment, to meet community needs over the next five years.  

“We know we need to focus and invest there,” Watson said. 

Other goals include reducing reliance on overtime, improving both employee and physician experiences, reducing worker injuries and patient falls, as well as slicing ambulance offload times and improving emergency department wait times. 

Watson called these “key” components of the hospital’s quality improvement plan.  

“I know they sound like they’re measures of the (emergency) department,” she said. “They are actually really strong indicators of what’s going on both broadly in the system and what’s also going on throughout our entire operation.”  

Board member Tim Lavoie said the hospital must be “future focused.” 

“And I think that this plan sets it up for us,” he added. 

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On X: @JeffreyOugler

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