The number of emergency department closures and a crisis in health-care staffing has increased and compounded in recent years, largely driven by the province’s inability to properly staff hospitals, Ontario’s auditor general has found.
A new probe into emergency departments by the province’s acting auditor general has found wait times are up, closures have become increasingly common, and some hospitals are being crippled with as many as one in four jobs left unfilled.
The audit found unplanned emergency department closures were “very rare” before 2019 and the beginning of 2020. In recent years, however, the number of closures has skyrocketed, with a lack of staff a key driver.
In a year from July 2022 to June 2023, the report recorded 203 emergency department closures in the province taking place at 23 hospitals, which were mainly in rural and remote parts of Ontario.
Despite the rising closures, the Ministry of Health has “never collected or tracked” information on staffing shortages or vacancies in emergency rooms. The acting auditor general’s team reached out to several hospitals and “all of them experienced a significant increase in nursing vacancies” between 2019-2020 and 2023.
At some hospitals the jump in unfilled nursing jobs was stark.
William Osler Health System, which runs hospitals in Brampton and Etobicoke, had a nursing vacancy rate of six per cent in 2019-2020; by 2022-2023, it had risen to 26 per cent. Sinai Health System in Toronto saw its unfilled jobs jump from three per cent to 19 per cent. And Sick Kids in Toronto went from an eight per cent vacancy rate to 22 per cent for full-time registered nurses.
“We noted multiple reasons for high staff turnover at emergency departments, especially among nurses,” the auditor general’s report said. “Factors included the higher pay and flexibility offered by private staffing agencies, as well as the introduction in 2019 of Bill 124.”
The Ford government has been under pressure through the pandemic for policies that critics say have led to a mass exodus of nurses from frontline roles.
Bill 124 capped wages for public sector workers at a one per cent increase per year for three years and was decried by nursing unions and advocacy agencies, who said it had forced many from the profession.
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