Opposition leaders commit to help Mississauga fund $450M shortfall for Trillium hospital expansion 

Leaders of Ontario’s opposition parties are pledging to help cover a $450 million funding shortfall for what will be a state-of-the-art 950-bed hospital located in the heart of Mississauga, after City Council voted to not contribute any money to the project.

In October, council members rejected a $450 million request from Trillium Health Partners (the hospital network responsible for Mississauga’s two hospitals and the Queensway Health Centre in Etobicoke) required as part of the $1.5 billion to fulfill Trillium’s “local share” responsibility outlined by the provincial government under Doug Ford for the redevelopment of Mississauga Hospital.

Council members cited concerns over the financial stress the $450 million request from Trillium would place on municipal taxpayers and said it was unfair to ask the city’s residents to cover such a large portion for a facility that will also be used by people outside the municipality. They also pointed out that the provincial government has not asked Toronto to pay for these “local share” contributions toward hospitals.

The PCs made it clear that they will not help fill the funding gap, previously telling The Pointer, “the Province will be funding the project through the agreed share amount as is the case with every single other hospital development across the province.” 

The expansion of the Queensway Health Centre in Etobicoke — part of Trillium’s broader redevelopment vision — was funded entirely by the Province and through the organization’s fundraising efforts. The City of Toronto was not asked to cover costs usually associated with the local share requirement for the expansion of William Osler’s Etobicoke General Hospital either. 

Ontario Liberal Party leader Bonnie Crombie, who has made healthcare a priority in her campaign, promising to provide everyone in Ontario with a familiar doctor in four years, told The Pointer covering the $450 million gap is something her Party would “look very closely at.” As the former mayor of Mississauga, she said she knows “how acutely that is punitive for cities,” and condemned the local share requirement as another form of downloading onto municipalities.  

“That’s a lost opportunity cost. That money could be invested in city priorities. All cities will have infrastructure deficits. It could go into building infrastructure. It could go into a new community center. That money is needed. It's not a municipal responsibility to be contributing to a hospital,” she said. “That's something I have to look very closely at, because I know how onerous that will be for the city, and it comes at the price of their own priorities. That money could be towards a new community center or road maintenance — whatever their priorities are.

“You're just giving money that's otherwise the responsibility of the province. I see it as more downloading to the cities.”

Green Party leader Mike Schreiner told The Pointer his Party’s platform has a commitment to lower the local share contributions that municipalities are currently required to make for new hospitals, particularly in rural communities.  

“We're looking at [local share contributions] across the board,” he said. “The challenges around meeting local share commitments are even more challenging in rural communities where you have a smaller tax base. So I think we need to be looking at lowering the local share contribution for all hospital projects.”

Liberal Party leader Bonnie Crombie has pledged to revisit the $450 million portion of the local share requirement for Trillium’s redevelopment of Mississauga Hospital.

(Paige Peacock/The Pointer) 

The burden, however, does not fall entirely on the backs of municipalities. 

The provincial government’s Hospital Capital Planning and Policy Manual, which establishes a framework for managing capital funding in the hospital sector, outlines that while municipal contributions can be included within a local share plan, the responsibility lies with the hospital management organization to ensure it “has a sound financial plan to manage its local share obligations,” which can vary depending on the size and scope of the project. “For any uncertain funding sources such as fundraising or revenue forecasts, the hospital must provide a contingency plan as part of its [local share plan] submission,” meaning Trillium is now on the hook to cover the outstanding costs required for the local share. 

NDP leader Marit Stiles told The Pointer the Mississauga Hospital expansion “is critical” for the region, “and the Ford government’s refusal to fully fund it is unacceptable.” Echoing the other opposition party leaders’ positions, she noted it is another example of forcing municipalities “to shoulder the burden of infrastructure” for something Stiles said “has always been a provincial responsibility.” She said the NDP would “reverse the years of unfair downloads to local governments, and ensure this vital regional healthcare facility gets built without putting undue financial pressure on the city and its residents.”

Advocating for healthcare infrastructure in Peel is not new for the Party, which, under former leader Andrea Horwath, brought forward a motion at Queen’s Park in 2021 calling on the PCs to provide the funding required to create 850 new hospital beds as part of Brampton’s Peel Memorial expansion, along with a new emergency room and a third hospital in Brampton. The PCs have long promised Peel Memorial would be expanded into an actual hospital (it is currently an out-patient preventative wellness facility) but their plan, under Ford, will not create a new hospital, and the PCs have failed to put any money for the construction of Peel Memorial’s expansion into the provincial budget. 

Recognizing that Brampton has the lowest healthcare services in the province per capita and is in desperate need of more hospital beds, the opposition leaders have committed to include phase two of the Peel Memorial expansion as part of their first budget if elected and they would ensure it is redeveloped into an actual hospital. The city has demanded 850 acute-care hospital beds, the PCs have only talked about 250 non-acute beds in what would not be a hospital. 

Crombie told The Pointer “it’s overdue” and is a commitment she “would honour," recognizing that “it's critical.” Schreiner said the absence of healthcare services in Brampton “has to change,” and that “we need full capacity hospitals with emergency departments that are properly funded [and] properly staffed.”

The PCs’ 2024 budget did not commit funding for Peel Memorial’s expansion or a timeline for its completion. No funding has been committed to the project despite Ford’s claims of building a “second hospital” in Brampton.

The PC Party under Doug Ford has not committed funding or a timeline for phase two of Peel Memorial in Brampton and has refused to fill the $450 million gap for the new Mississauga Hospital.

(Trillium Health Partners) 

The situation in Mississauga, with $450 million outstanding, remains unclear. The decision by City Council members to not provide the amount could push the project's construction back, according to what Trillium told elected officials when the money was requested. A City staff report in October stated that Trillium “must secure the municipal contribution” to “proceed with the hospital construction.”

Trillium president and CEO Karli Farrow previously told council the health network is “moving forward with the government to ideally achieve financial close by February” and that once the financial plans are finalized, the organization would have shovels in the ground by this spring. Construction is expected to take eight years before the new hospital is opened.

A Trillium spokesperson previously told The Pointer Mississauga's hospital expansion project was in the process of finalizing the design, schedule and pricing required under the development phase, which was anticipated to be completed in 2025 before entering into a fixed-price Project Agreement, “at which point the final cost will be released publicly” (the organization has not revealed the current cost estimate of the project). 

But a report released in December by Ontario’s Auditor General revealed the estimated costs for the redevelopment of the new state-of-the-art project are more than $4 billion higher than the approved budget. Though the total project cost has not been finalized, latest estimates from October anticipate the rebuild and maintenance through the period of the contract is now projected to cost more than $16 billion, exceeding the current approved budget by over $4 billion for the design, construction, financing and maintenance over 30 years including ancillary costs.

Among several findings, the audit also revealed that if cost savings are not found, the hospital’s ability to offer the full range of services could be in jeopardy. It warned that, “to address their budget contracts, THP (Trillium Health Partners) may need to consider removing key clinical requirements from the design, with [Ministry of Health] approval, which could impact the quality and scope of health-care services provided.” It also found that Trillium would need to request additional funding. 

Trillium has not commented on the findings in the audit or how it would impact the construction timeline. 

“To ensure Mississauga residents continue receiving the essential, high-quality care they need and deserve, we are working with all our partners to advance The Peter Gilgan Mississauga Hospital as planned,” a Trillium spokesperson told The Pointer on Wednesday. A new parking garage was opened at the Mississauga Hospital in November and the former garage has since been closed and demolished to make room for the future hospital, “marking a key pre-construction milestone.”

“The project remains on track, and work is underway to prepare the site for a 2025 groundbreaking. In collaboration with all our partners, we are working to deliver this much-needed health infrastructure project to our community.”

Email: [email protected] 

Twitter: @mcpaigepeacock

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