Niagara municipalities rallying against centralization of frontline healthcare as funding for new $3.6B regional hospital stalls

On August 1, Niagara Health issued a news release celebrating the two-year mark of construction on the state-of-the-art South Niagara Hospital which promises world class, patient centred health care to the region.

The projected budget for the new build is $3.6 billion with the provincial government committing to 90 percent of “eligible construction costs”.

Niagara Health, responsible for the hospital’s management and fundraising for the amount not covered by Queen’s Park (the remaining capital including the cost of equipment and furniture), faces two challenges.

The $230 million of community funding that is required for the project, often called the local share contribution, needs commitments from lower tier municipalities, and some are balking at the amount they have been asked to provide; while residents in those same municipalities are questioning the move to a more centralized model of frontline healthcare delivery, at the expense of local services that are now in jeopardy.

A rendering of the new South Niagara Hospital being built in Niagara Falls.

(City of Niagara Falls)

The fundraising drive is not having much success outside the City of Niagara Falls and Niagara’s regional government.

Niagara Health CEO Lynn Guerriero was recently in Welland asking for $17.8 million for the new South Niagara site and was asked if the City of Niagara Falls would reciprocate when money is needed for the future renovation of the Welland Hospital. She said yes, explaining the Welland site is also a regional hospital.

Tension between lower-tier municipalities over the funding and delivery of healthcare across Niagara has mounted. 

The increasingly regional approach, with larger hospitals in the three biggest centres (St. Catharines, Niagara Falls and Welland), has drawn concern across smaller municipalities, where the slated closure of facilities means residents will have to drive much farther to receive a range of healthcare services.

When Guerriero requested $5.8 million from the Town of Pelham for the new hospital in Niagara Falls, she said “NH would not be back to the town again asking to fund the South Niagara site but may be back again to ask for funding for the redevelopment of the Welland site.”

Eventually, at the start of the month Pelham council members only approved a $1 million commitment, paid off over 15 years, for the new build in Niagara Falls, which is all the town can afford, according to councillors and staff.

The Town of Fort Erie previously withdrew from any commitment for the South Niagara Hospital project. It remains unclear where Niagara Health will make up the funding. It is still waiting for responses from Welland, Port Colborne and Wainfleet.

A major concern in communities including Fort Erie and Pelham is the loss of local facilities to make way for the regional model. 

“Fort Erie Healthcare SOS is an advocacy group within our community to highlight our need to be able to access our Urgent Care and to promote the return to 24/7 access to healthcare in Fort Erie, Port Colborne and at the Welland Hospital,” the organization explains. 

“Since the Niagara Health System and the Ontario Government have tried to reorganize the way healthcare is delivered in small and rural communities; they have increasingly taken away our services in order to provide for large urban centers. We do not want to stop the build of the larger centers but we do expect to have access in our own community. We know that minutes matter and at least our Urgent Care could stabilize us for transport.”

The Douglas Memorial Hospital in Fort Erie will see its urgent care centre closed in 2028 and many residents fear the whole facility might be shuttered. 

(Town of Fort Erie)

The advocacy group has launched an effort to save the Douglas Memorial Hospital and its urgent care centre, which residents fear might be closed or significantly downsized under the shift to a regional frontline healthcare model.

The urgent care facility, along with a similar one in Port Colborne, saw summer hours curtailed, sparking outrage among local residents earlier this year. Both are slated to be closed once the new South Niagara Hospital in Niagara Falls is operational in 2028.

The facilities in Port Colborne and Fort Erie are called hospitals but neither is a full-service facility.

“Fort Erie has consistently been left out of Niagara Health’s plan; in mid winter there are times when the highway is closed due to weather conditions which means our access at night is shut off completely,” the advocacy group highlights. “We deserve full access; we are not willing to give up on our lives or that of our children’s so a new hospital can be built in another city. This is shameful and we need to make sure that we have access to the care we need, when we need it.”

At the end of June Fort Erie officials released a statement outlining a proposal to protect the future of the town’s hospital. 

“On Tuesday, Mayor Wayne Redekop, accompanied by Councillors Joan Christensen, George McDermott and Tom Lewis, CAO Chris McQueen and Health Care Services Co-Ordinator Alice Preston attended a meeting of the Niagara Health Board of Trustees to urge reinstatement of hours of operation at the Fort Erie Urgent Care Centre, request that it work with and support the Fort Erie and Niagara Region physician recruitment efforts and outline Fort Erie’s reimagining of how the Douglas Memorial site can be better utilized to serve the residents of Niagara.”

Town officials described the “use of 130 to 145 acute care beds in Niagara Health’s 3 main hospitals for non-acute patients” as having a “crippling effect on its ability to manage its Emergency Departments. The result is unnecessarily long wait times in the EDs because patients needing admission cannot be placed in an acute care bed, patients have to be kept in unintended spaces and ambulances cannot off-load patients. When ambulances are left sitting for hours at EDs, paramedics cannot engage in their critically important service to the public because they and their ambulances are out of service while they wait to release their patients to the hospital. This misuse of acute care beds means that up to $50 million annually is inappropriately allocated by Niagara Health and Regional taxpayers pay between $5-8 million annually while ambulances sit idle at hospitals.”

Underlying these problems is the shift to a centralized model, advocates and local officials say.

“By establishing alternative levels of care beds at Douglas Memorial and fully utilizing its Urgent Care services, NH can significantly relieve pressure on its acute and emergency operations, reduce ED wait times and EMS off-load delays, improve patient care and better utilize the millions of dollars allocated for those services,” the June 27 press release proposed. “Fort Erie’s proposal also calls for improved diagnostics, a concentration of health care services and the potential for education and training programs for a range of desperately needed health care providers."

Redekop, according to the release, requested a meeting with the Minister of Health “to review the Town’s Douglas Memorial proposal.”

In Pelham, the announcement by Guerriero that Niagara Health would be back to request funding for the Welland site’s expansion was of great concern to Ward 2 Councillor John Wink who was shocked at the $5.8 million requested for the Niagara Falls site: “They did not come to our community to ask for funding when they built the St. Catharines site; and now they will be coming back again to ask for funds for Welland.”

On June 25 it was announced that in the 2024-2025 fiscal year Niagara Health had a $26 million deficit, which more than doubled from the previous year. Meanwhile property taxpayers across the region are being asked to cover more of the costs of frontline healthcare.

The Pointer asked Niagara Health about how it determined funding requests for lower-tier municipalities to cover local-share needs for the Niagara South Hospital and the upcoming expansion of Welland’s facility. No response was provided. It remains unclear if equitable funding criteria were established to ensure taxpayers across the region would be treated fairly. The management of service delivery in different communities, and the need to ensure residents in each municipality are getting what they pay for are also being questioned.  

To build the new site at the corner of Bigger Road and Montrose Road in Niagara Falls Niagara Health announced it would approach six southern-tier municipalities to raise approximately $230 million to cover the local share amount Niagara Health has to secure.

Any municipality can choose to say no, as Mississauga did last year, when asked to cover $450 million for what will be one of the largest hospitals in North America, being built in the heart of the city. 

Niagara Health asked Niagara Falls, Welland, Wainfleet, Pelham, Port Colborne and Fort Erie for a per capita contribution of $340.63.

Fort Erie was asked for $10.5 million and Port Colborne for $6.2 million while at the same time their urgent care centre hours were cut back for this summer.

Citing staff shortages Niagara Health announced Port Colborne’s urgent care facility would be closed every Saturday until September and the Fort Erie urgent care site would be closed every Friday until September. The controversial move was the only way emergency departments in the three bigger hospitals in St. Catharines, Niagara Falls and Welland could be fully supported.

The relationship between Niagara Health and the Town of Fort Erie has deteriorated to the point that Mayor Redekop called for Guerriero’s resignation, while council withdrew its original commitment of $3 million for the Niagara Falls site; Niagara Health had asked for $10.5 million.

Port Colborne was asked for $6.2 million late last year, sparking outrage among residents furious over the planned closure of the local hospital in 2028, when the Niagara Falls site comes online. 

Local residents were surveyed about the $6.2 million request for the South Niagara Hospital.

A majority of residents did not support a $6.2 million contribution because they felt Port Colborne would not benefit; 83 percent of respondents reported Port Colborne requires its own urgent care centre open 24 hours everyday. 

On July 8, Port Colborne council addressed a letter from Niagara Health asking for a decision on the $6.2 million request by September 12.

Council decided to ask for more time in order to work out a solution to Port Colborne’s future healthcare needs.

Resident Betty Konc (a former mayor of Wainfleet) who has been fighting to save the hospital since 2009 expressed her frustration to The Pointer. “Did you know that the Port Colborne urgent care treats almost 22,000 patients a year? We also have the lowest ratio of patients/doctors in all the region… Our community absolutely needs to retain, at minimum, our fulltime Urgent Care Centre.”

Niagara Health attended the April 8 Welland City Council meeting, asking the municipality for $17.8 million to help fund the new hospital in Niagara Falls.

Council members directed staff to “explore” financial options.

The Pointer spoke to Welland Councillor Graham Speck, the only member who voted against committing the money. “One of the reasons I voted against this was because our Welland hospital is going through a huge renovation and Niagara Health told our council that they will be coming back to us to help fund that also. That is where our priority should be because residents of Welland can’t afford to fund both.”

According to the Niagara Health website, Wainfleet has been asked to commit $2.2 million, while the City of Niagara Falls has already pledged $30 million plus $11 million for the land the new site is being built on.

Revenue primarily from parking is expected to cover $80 million-$90 million. 

In a recent op-ed Niagara Falls NDP MPP Wayne Gates wrote, “charging people to park at hospitals is a disgraceful tax on suffering. It’s wrong. It’s cruel. And it needs to end.”

Requests from local officials and residents to have parking fees eliminated have fallen on deaf ears. Guerriero has stated at every official request for funding that if Niagara Health does not raise all the required money, the shortfall will affect the level of patient care.

Betty Konc calls those comments “extortion”.

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