Keep urgent care in smaller communities, Niagara residents tell Ontario party leaders

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For Jude Campbell, a Fort Erie, Ont., resident with heart trouble, "it's just scary," knowing the closest emergency room is at least a 30-minute drive away.

There is no hospital in Fort Erie, only an urgent care centre with limited hours. Niagara Health plans to close it by 2028. 

In 2023, hospital network Niagara Health reduced the operating hours at its urgent care centres (UCCs) in Fort Erie and nearby Port Colborne, going from all-day operation, to 10 a.m. to 10 p.m., with patient intake ending at 8 p.m.

Campbell, 78, says the decision effectively left residents without timely access to care at night, because whereas they could once go to the UCC, now ERs elsewhere in Niagara are the only options.

The changes were "to help maintain capacity" at ERs in Welland, St. Catharines and Niagara Falls, Niagara Health said in an email.

But many Niagara residents feel the changes have left them without adequate level of service they need — and are hoping to be heard by those running in the provincial election.

"It's very sad. You work your whole life and pay all your taxes and are entitled to these necessities. They're being taken away and no one is listening," said Margaret Unruh, who also lives in the Niagara Region.

Campbell and Unruh are members of Fort Erie health care SOS, an independent citizen's group that formed to oppose that decision and advocate for health services in the Niagara town.

They spoke to CBC Hamilton, alongside fellow Fort Erie health care SOS members Barbara Wilkinson, in light of the election campaign underway. 

Hospital network said closures needed to preserve emergency care

When Niagara Health made the changes to the two UCCs, they were seeing "an average of one patient every three hours" at night, while maintaining staff "urgently needed to keep our [ERs] open."

UCCs are different from ERs in that they treat injuries or illnesses such as strains, sprains, minor cuts or burns that cannot wait for a scheduled doctor's appointment, the hospital network says on its website. ERs are for serious and life-threatening conditions.

Ultimately, Niagara Health plans to close the Fort Erie UCC when it opens a new hospital in Niagara Falls in 2028.

In a February opinion column posted to the Niagara Health website, CEO Lynn Guerriero said residents' concerns "highlight the community's deep commitment to ensuring local access to health care, a commitment Niagara Health shares."

Cuts made under previous governments

Formerly called Douglas Memorial Hospital, the Fort Erie UCC was converted from an ER in 2009 when Liberal Dalton McGuinty was premier.

This provincial election, the Fort Erie health care SOS group is calling on candidates to commit to restoring all-day service and turn the UCC back into a full hospital. 

"Communities feel really unsettled when facing the closure of any timely emergency service," said Dr. Alan Drummond, an ER physician and family doctor in Perth, Ont.

Months after the Fort Erie ER was converted to a UCC, a local teen died in a collision. Her family and critics of the emergency department's conversion questioned whether she would have survived had she been able to get care there. In a subsequent coroner's inquest, a jury made no recommendations about ERs.

Drummond told CBC Hamilton cases like that leave a lasting impact on communities and he understands why people would be upset about further reductions.

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Drummond is a member and past president of the Canadian Association of Emergency Physicians who has been vocal about ER closures.

Southwestern and northern Ontario have been experiencing these largely on the basis of nursing shortages, Drummond said, in part due to pandemic burnout and the "ham-handed" way the provincial government dealt with nurses. 

Ontario has failed to maintain "human health resources," Drummond said, so going forward, Ontarians "probably have to readjust our thinking."

A shortage of health professionals means it may no longer be realistic for smaller communities to maintain ERs and UCCS.

"Wouldn't it be wiser to have a dedicated centre of excellence" over multiple smaller hospitals all struggling to maintain services, he questioned.

Drummond also cautioned against prescribing too much value to a UCC as a source of timely care in an emergency. Really, he said, someone in serious need needs to go to an ER. "You don't want to end up in a less optimal situation."

Niagara residents say health care is top issue

Having a hospital in one's community means it's much easier for family members to visit patients, serving as advocates and making them feel better. It also makes it easier for people who don't drive to get to appointments, the SOS group says. 

Urgent care in Port Colborne and Fort Erie is "essential," because people without family doctors need options for treatment outside of hospitals, Sue Hotte, chair of the Niagara chapter of the Ontario Health Coalition said. 

And overall, Hotte said, health care in Niagara is in a "state of crisis." People regularly share their negative experiences in hospitals, she said, which include lengthy waits and being treated in hallways.

For Colleen Sibeon, 43, health care is the number one election issue. The Thorold, Ont., resident who works at an electronics company worries about hospitals closing down and wants to know how candidates plan to fund the public health system. 

Sibeon's husband is "high-risk" and the two work hard to limit their exposure to illness by wearing masks in public and avoiding socializing when lots of people are sick. They want to limit their reliance of the health-care system, Sibeon said, because they're "so scared of what's not there."

Carole Mason of St. Catharines told CBC Hamilton she'd like to see the province invest more in health care. 

"Instead of giving everybody $200, put that into health care. That's what should have been done because we need new doctors and the doctors coming into the country need to be able to work," the retired welding instructor, 85, said. 

What the parties say

Here's some of what the major political parties are promising when it comes to ER closures and the situation in Niagara.

Progressive Conservative Party of Ontario

• The PCs said they invested $85 billion in health care "this year alone," including in over 50 hospital redevelopment projects, such as West Lincoln Memorial Hospital in Grimsby and the new Niagara Falls hospital. Those projects add "nearly 600 new beds across the region," they said.

• The party said the PC government invested $44 million to "tackle" ER wait times and $10 million to upskill 1,000 nurses to work in ERs, as well as $2 million in primary care across Niagara.

• The PCs will "continue to support" Niagara Health's master plan, including its decision to change the roles of the Port Colborne and Fort Erie UCCs "so they can provide care that better meets the needs of the local communities, including primary care services." 

New Democratic Party of Ontario

• An NDP government would "restore services" to the UCCs in Port Colborne and Fort Erie, "so that no one needs to drive through traffic or winter storms to get the care they need," a party spokesperson said.

• The NDP would also "open a fully-staffed, full-service hospital to support people in Welland for decades to come."

• The NDP would "lead a targeted recruitment and retention initiative" to "bring back" health-care professionals, pay workers "fairly," fund administrative support "to reduce the burden of paperwork," and work to get more internationally-trained doctors into ERs.

• The party also says it would work to hire doctors in "areas with the greatest need," and increase funding for programs to support remote communities.

Ontario Liberal Party

• The Liberals did not respond to specific questions from CBC Hamilton but have said they would guarantee every Ontarian will have a family doctor close to home by the end of their first term, if elected.

• The Liberals say they would invest $3.1 billion to "attract and retain 3,100 family doctors by 2029," partly by doubling medical school spots and integrating internationally trained doctors more quickly.

• The party says a Liberal government would pay all nurses and personal support workers a living wage.

Green Party of Ontario

• The Greens did not respond to specific questions from CBC Hamilton but have said the party would expand public, 24/7 non-urgent clinics as an alternative to ERs.

• The Greens would recruit 3,500 family doctors to make sure all Ontarians have one within three to four years.

• The Greens say they would pay nurses, doctors and personal support workers the same wage to better serve remote areas, and halve the cost rural communities pay for new hospitals.

• The party also said a Green government would cover travel for health-care workers to treat people at home, make more nursing program spaces and approve international health-care workers faster.