Province recommits investment for massive Mississauga Hospital redevelopment in 2023 budget
Detailed on the pages of Ontario’s 2023 financial blueprint, the PC government announced a recommitment of funding to support the Trillium Health Partners’ broader redevelopment projects to build a new, state-of-the-art Mississauga Hospital in the city centre and expand another existing facility just across the border in the Southwest corner of Toronto.
The announcement follows the PC commitment first introduced in December 2021 for a massive new rebuild of Mississauga Hospital, which will operate almost a thousand beds (it currently has about 750), and a second expansion within the Trillium Health network, at its Etobicoke ambulatory-care site, which will receive 350 new beds. Trillium Health Partners (THP), the hospital network responsible for Mississauga, which also operates the Queensway Health Centre in Etobicoke, labelled the project Trillium HealthWorks, the organization’s health infrastructure renewal plan aimed at responding to the community’s future needs.
“Trillium HealthWorks, which includes building The Peter Gilgan Mississauga Hospital, and expanding the future home of The Gilgan Family Queensway Health Centre, will help shape the future of health care for our community and beyond,” a THP spokesperson wrote in an email. “This critical health care investment will help THP meet the needs of the growing communities of Peel Region and West Toronto. It will mean more beds, shorter wait times, and greater specialization closer to home.”
The PC government’s latest budget document announced desperately needed funds for Ontario’s hospital infrastructure. In the 2023 blueprint, to increase capacity, the PCs announced more than $48 billion — up from $40.2 billion announced in the 2022 budget — over the next 10 years to go toward hospital infrastructure. Of the $48 billion hospital infrastructure investment plan, funding is expected to be allocated toward the repair and replacement of existing hospitals, as well as to build new hospitals and expand the capacity of existing hospitals, including over $32 billion in hospital capital grants, to support more than 50 hospital projects that would add 3,000 new beds over 10 years to increase access to care.
The announcement is part of the government’s commitment to funding much-needed projects across parts of Peel, where residents experience longer hospital wait times than almost anywhere else in the province and where healthcare facilities continue to struggle with the rapidly rising demand.
The provincial target is for patients to be admitted within 8 hours of their arrival in the emergency department. Trillium’s two Mississauga hospitals are among the worst performing: Credit Valley Hospital has an average wait of 43.8 hours, the second longest in Ontario; Mississauga Hospital isn’t far ahead, at 29.5 hours. The best performing hospital is St. Joseph’s Health Care London, at 3.6 hours.
Mississauga’s healthcare system is one piece of the puzzle that desperately needs to expand with the rest of the city.
THP sees nearly 1.7 million patient visits each year — a number that will skyrocket as the Region faces substantial population growth (Mississauga has been asked to accommodate 120,000 new homes by 2031 under the PC housing plan).
Over the past five years, THP has seen a 14 percent increase in the number of people coming through the emergency departments and urgent care centre, and a seven percent increase in the use of outpatient services, according to its 10-year Strategic Plan, which notes the organization “will experience more demand for services than any other Ontario hospital in the next 20 years, and the hospital’s infrastructure has not kept pace for its size and the complexity of care delivered.”
Mississauga Hospital was originally built at 100 Queensway West in 1958 to serve a community made up of villages, farms and townships. In 1986, the year after Credit Valley Hospital, the second in the city, was opened, the population of the area known today as Mississauga was 374,005. During that time, the Region of Peel experienced exponential population growth. Peel’s population exploded from 260,000 in 1971 to about 1.6 million currently; and it is expected to reach almost 2.3 million in less than three decades, according to Hemson Consulting. In Mississauga alone, the 2021 census pegged the City’s population at 721,599 — nearly a 93 percent since 1986, but it does not have the hospital infrastructure in place to accommodate the growth it has experienced.
In its 10-year Strategic Plan, Trillium Health Partners predicts the organization will experience more demand for services than any other Ontario hospital over the next two decades.
(THP 10-year Strategic Plan)
Keeping in line with this trend, by 2041, the communities THP serves are set to grow by 45 percent. The majority of the population increase will take place before 2035, with 650,000 additional residents projected in the surrounding communities. This increase will see THP’s catchment rise from 2.2 million to 3.2 million residents by the early 2040s.
According to THP’s most recent annual report, the hospital currently has 1,397 beds across its three facilities. The hospital has not confirmed how many were in Mississauga, but THP’s website lists 382 beds at Credit Valley and the University of Toronto’s medical program, which uses Mississauga Hospital as a teaching facility, says it has “827 acute, rehabilitation and chronic care beds”. Combining these numbers for a rough total of 1,209 beds and dividing the figure by Mississauga’s 2021 population shows expansion is badly needed. The city has roughly 1.6 beds per 1,000 residents, above Brampton’s disturbing allocation of 0.9 beds, but still well below the Canadian average of 2.5 per 1,000 residents.
“Investments have not kept pace with the growth and changes in [the] community,” THP’s strategic plan admits, describing the network as “under-resourced for the size and needs of the community.” It notes no hospital system in Ontario will receive more demand for acute services across the next two decades.
To accommodate the growing concerns of the need outpacing capacity, the Hurontario Street and Queensway building, to be named The Peter Gilgan Mississauga Hospital, will be a full reconstruction of the existing hospital and house more than 950 hospital beds, one of Ontario’s largest emergency departments, new surgical platforms that will increase the number of operating rooms to 23, up from its current 14, new advanced diagnostic and imaging capacity, along with additional pharmacy and clinical lab space. A large parking structure will also be built, which is already underway.
At full build-out it will be one of the largest hospitals in North America.
The Etobicoke facility in Southwest Toronto will not convert Queensway Health Centre (which is entirely separate from Mississauga Hospital at the other end of the Queensway) to an actual hospital but with the addition of more than 350 new beds to provide complex continuing care and a range of rehabilitation, it will create increased capacity for acute care at both of the Mississauga hospitals Trillium operates.
A rendering of the 22-storey new Mississauga Hospital.
(Trillium Health Partners)
According to the March 2023 Infrastructure Ontario Market Update, the Trillium investment will be as much as $3 billion, while the announced expansion of William Osler’s Peel Memorial (which is not a hospital) in Brampton will cost between $200 and $500 million for its Phase 2 development. The Pointer previously reported as of the June 2021 update, the Trillium construction work had already been awarded, while the Peel Memorial work had not been awarded to a building partner, suggesting the Trillium projects were further ahead than the much smaller one being managed by Osler, which operates Brampton's major healthcare facilities. The March update confirmed construction work for Peel Memorial Phase 2 has since been awarded.
THP noted early work on both the organization’s reconstruction and expansion projects are underway with parking structures currently under construction at both sites. Parkade construction at the future home of The Gilgan Family Queensway Health Centre is progressing with the concrete superstructure nearing completion. The next stage of work will include electrical and mechanical rough-ins and elevator contractors commencing work, a THP spokesperson confirmed. Contractors also spent the winter advancing the concrete substructure of the new parkade at the site of The Peter Gilgan Mississauga Hospital.
A request for qualifications (RFQ) was issued in 2021 and closed in early 2022 for The Gilgan Family Queensway Health Centre, and a request for proposals (RFP) was issued in October of last year by Infrastructure Ontario and THP. Following the RFP stage, Infrastructure Ontario and THP will close the procurement phase with the successful proponent selected to build and finance the project, which is anticipated to take place this year.
The RFP for The Peter Gilgan Mississauga Hospital closed in the fall of 2022 and on March 10, THP and Infrastructure Ontario signed a development phase agreement with ED+PCL Healthcare Partners — the development partner selected to further develop the project requirements. It is expected that ED+PCL will enter into a fixed-price project agreement with THP to finalize the design/build/finance and maintain the project within the next two years, THP said.
“This step marks the latest milestone in moving another step closer to breaking ground on the new hospital, which is anticipated to take place in 2025,” the spokesperson explained. “The construction schedule of the projects will be determined based on the successful bidder’s construction schedule.”
Another rendering of the massive new Mississauga Hospital.
(Trillium Health Partners)
As Mississauga flashes its shiny investments paid by Ontario taxpayers, Brampton currently has one lone full-service hospital — Brampton Civic. The city has been waiting on funding for the Phase-2 expansion of Peel Memorial, to possibly see it converted to a full-service hospital in the rapidly growing city, where residents commonly avoid going to the lone full-service hospital for fear of being stacked in an already crowded hallway. City council has previously stressed the need for roughly 850 more hospital beds to reach the provincial per capita average. The Memorial expansion, according to previous presentations by Osler, will only include 250 beds (it currently has no in-patient beds) and almost all of these will be for non-acute care. The 2023 budget notes support for local hospital projects, including transforming the existing site and urgent care centre at Peel Memorial in Brampton into a new 24/7 inpatient facility, in partnership with the William Osler Health System, to advance the development of an emergency department in one of Ontario’s fastest growing communities. Memorial’s expansion has been described as a supportive facility to help Brampton Civic create acute-care capacity by offloading patients who do not need the support of a full-service hospital.
A recent review from the province’s financial monitor included several alarming projections about the PC government’s healthcare spending which projected a $21.3 billion shortfall in the health sector by 2027/28. The current spending plan, according to the Financial Accountability Office of Ontario, will not meet existing commitments or growing demand and existing problems in the healthcare system are “expected to persist” and get even worse as a result of underfunding and a shortage of frontline workers. According to the FAO, the government has allocated roughly $87.8 billion to be spent on health care by 2028. Spending needs, however, are expected to grow to around $93.8 billion, meaning the province has not allocated sufficient funds to support existing health sector programs and announced commitments.
The historic redevelopment of Mississauga Hospital, which is set to house almost a thousand beds, will come with a hefty price tag for the city as property owners will likely have to cover part of a local share requirement through their annual municipal tax bill.
While the bulk of funding for the work will come from the Ministry of Health, a local share will also be needed. This figure has not yet been decided, but will be in the range of 15 to 25 percent of the overall capital cost, THP explained.
In an email to The Pointer, David Longley, vice president of THP’s capital planning and redevelopment, noted the province covers 90 percent of the cost of eligible hospital construction and 100 percent of the planning costs. The remaining 10 percent of construction costs, major equipment, and technology required in the hospital is covered by the hospital’s “local share” — meaning the portion of total project costs required to be raised by the local community, either through fundraising, hospital revenue and other sources.
The Peter Gilgan Foundation has already provided $105 million and in March, THP received a pledge to match donations up to $75 million from Orlando Corporation, a Mississauga-based industrial real estate developer, for a potential total of $150 million — the largest corporate donation for a hospital in Canada’s history. The local organization said it would donate up to $75 million to THP and Trillium Health Partners Foundation, matching donations from the community over the next 10 years, with payments made annually. Of that amount, $50 million would go toward the new hospital, $15 million to research and innovation as part of the Institute for Better Health, and $10 million for a new in-patient mental-health facility.
"Trillium Health Partners is uniquely positioned to create a new kind of health care by virtue of our size, the diversity of the community we serve and our ongoing commitment to system change, driven by our clinicians, staff and scientists, and supported by our committed Foundation team," Karli Farrow, president and CEO of THP said at the time of the announcement. "Thanks to this most generous gift by Orlando Corporation, we will gain new and expanded hospital capacity, including for inpatient mental health care, and be leaders in health system innovation to ensure no one gets left behind."
Beyond THP’s local share requirement, the municipal government is generally expected to also contribute toward the 15 to 25 percent local share Queen’s Park has traditionally asked for, as area residents benefit the most when hospital investments are made in their backyard.
However, a City of Mississauga spokesperson confirmed in an email that a City Hall share of the funding for the expansion has not been identified or requested at this time.
Email: [email protected]
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