End Poverty and Engage Community to Reduce Hospital Spending
re. Ontario hospitals caught in budget squeeze

(letter as submitted)
Once again, Ontario hospitals are contemplating service cuts in order to balance their budgets, and once again, community groups are rightly opposing them.

Is there a way to end this recurrent conflict, reduce hospital spending and improve Ontarians' health? Abundant research evidence suggests that there is: the short answer is to focus on preventing illness and injury and thereby the need for hospital services.

The most effective way to do this is to tackle the social determinants of health - poverty, inequality, racism, pollution. If the Governments of Canada and Ontario made a stronger effort to build affordable housing, invest in regulated non-profit childcare, expand job training, establish living wages, support new immigrants, and clean up the environment, they would go a long way to containing medical costs and improving population health.

There is something hospitals themselves can do too. Taking a cue from the Wellesley Hospital, a former teaching hospital in downtown Toronto closed by the Harris Government in 1998, they can give clients and community members a more meaningful voice in hospital decision-making. When the Wellesley created a powerful Neighborhood Relations Committee to improve hospital-community relations, Community Advisory Panels to guide specific services, and governance positions for community activists, it not only improved its responsiveness to community needs but also erased its fiscal deficits.

These are not new suggestions. But they do bear repeating, for, with few exceptions, governments and hospitals have taken many steps backward and only baby steps forward in recent years.

Jeff Denis, Toronto