As Ontario touts major health-care investments and hospital unions highlight systemic underfunding, Health Sciences North leadership says the reality on the ground is a hospital that doesn’t have the capacity to serve the community

At the same time the provincial government is boasting historic health-care expansions, hospital unions accuse the ministry of systemic and intentional underfunding. For Health Sciences North’s president and CEO, David McNeil, the truth lies somewhere in the middle.

“There’s different interests and positioning, but I think everybody acknowledges that the health care system is under significant fiscal and capacity constraints. There is no question about that,” he told Sudbury.com. “There hasn’t been massive cuts in the health-care system, so I think that’s part of the nature of the conflict in the dialogue, but the Ministry has invested substantively in health care at HSN. We have a very strong working relationship with the Ministry of Health on our capacity pressure.”

However, the hospital is still navigating the reality of being at 108-per-cent capacity on an almost daily basis, McNeil said.

Facing a severe capacity crisis, McNeil told Sudbury.com that HSN is routinely housing more than 637 patients despite only having 528 physical beds, forcing many into unconventional spaces: hallways, tub rooms, the Emergency Department or in temporary placements such as retirement homes.

“We know that our physical capacity has to expand, and we know there’s still needs that we could meet within our community that remain unmet,” said McNeil. “But those are decisions that have to be made around what service levels we’re going to be funded for.”

Competing narratives

But while the government frames its plan as a massive expansion of health care capacity, a report from Ontario’s largest hospital union argues that the province is actively starving the public system, causing structural deficits and worsening patient care.

In May, the Ontario Council of Hospital Unions and Canadian Union of Public Employees released a report authored by the Canadian Centre for Policy Alternatives, then undertaking a cross-province tour, hosting press conferences in major cities.

In Sudbury on May 20, representatives said there were increasing wait times in both the emergency room and for admission to Health Sciences North. They also said the hospital is carrying an ongoing deficit.

Called Failure by design: Ontario’s deepening hospital crisis, the report argued that the government’s figures are misleading and that the system is suffering from a structural underfunding crisis that predates the recent stresses. They contended that core public hospital funding has not kept pace with inflation, leading to job cuts and declining staffed bed counts, and what they see as a pivot to private clinics.

Asked for an interview to comment on the report, the Ministry of Health declined. However, a spokesperson sent a statement dismissing it, calling the report “misguided,” and pointing instead to a list of multi-billion-dollar health-care investments across the province, as set out in their Health System Stability and Recovery plan. The ministry attributed current hospital capacity issues to staff fatigue and stress, and emphasized investments since 2018, such as adding thousands of health care workers, funding surgical backlog reduction, and expanding private-public partnerships to increase capacity.

When the report was issued and Sudbury.com asked for comment, HSN spokesperson Jason Turnbull stated in an email that “demand at HSN remains extremely high.”

Consistently over-capacity, Turnbull told Sudbury.com in the statement that the Ministry of Health is “aware of these challenges.”

“We are actively working with them on long-term capital expansion planning that would see HSN increase its current bed capacity at the Ramsey Lake Health Centre in the Emergency Department, Pediatrics, Mental Health and Addictions, as well as inpatient units,” Turnbull wrote. “We continue to work closely with Ontario Health and the Ministry of Health and appreciate recent investments to support our long-term financial sustainability so HSN can continue to provide specialized health care services in Northeastern Ontario for years to come.”

Sudbury.com also requested an interview with McNeil, the hospital CEO, for a more fulsome understanding of the situation. We were granted a 10-minute phone interview on May 28.

Permanent state of triage

Wait times have improved slightly and the budget has balanced for the fiscal year 2025/26, McNeil told Sudbury.com. But also, HSN operates in an almost permanent state of triage, managing a structural deficit and overcrowded halls.

McNeil frames the solution to this through the lens of hospital stabilization and proving the “wise use of resources” to the Ministry of Health to secure future funding.

“We do know that we have to grow as an organization. We know that our physical capacity is limited. We have 528 physical beds here at HSN, but most days we have over 637 patients admitted,” McNeil said. “Now, we have some of those patients, about 47 of them, that reside in a retirement home where we provide their care. They tend to be lower acuity patients, but they’re still in-hospital patients, and the balance of the patients are in hallways and other options.”

The physical limitations of HSN raises two questions: Does the hospital need a funding boost, and; because of the hospital’s bed constraints, are patient needs going unmet?

McNeil said “yes, we could always use more money, and yes, we could always provide more service and more care,” but added that he feels “well positioned to do that as an organization, very capable of doing that. So that’s where I’ll leave that.”

The hospital is ending the current fiscal year in a good financial position, he said, but there is a projected “significant deficit for the end of the next fiscal year.” McNeil refers to this ongoing funding gap as a “structural deficit,” driven by the reality of starting the year without knowing all expected funding (some of which arrives later in the year). A clearer picture of the projected deficit for the next fiscal year is expected by the fall, he said.

To ensure the sustainability of health services and demonstrate wise resource use, the hospital is actively working with the Ministry of Health through the hospital sector stabilization process.

McNeil said the emergency department sees approximately 77,000 patients annually and approximately 85 per cent of patients receive treatment and are safely sent home. The wait time for 90 per cent of these patients is nine hours, which matches the provincial average.

The remaining 15 per cent of patients require admission to the hospital, but because the hospital lacks sufficient bed capacity, these admitted patients experience long delays waiting in the ED.

However, McNeil said the time it takes for an admitted patient to get an inpatient bed (90th percentile) has substantively improved. It dropped from 43.6 hours at the end of the 2024/25 fiscal year down to 32.7 hours by the end of the most recent fiscal year, 2025/26.

The numbers paint a stark picture of a system that seems stretched to its limit. McNeil said a 10-hour reduction in emergency room wait times for admitted patients signals hard-fought progress, but the data reveals that on any given day, more than a hundred patients are still receiving care in retirement homes, unconventional spaces, or hospital hallways.

Jenny Lamothe is a reporter with Sudbury.com, covering vulnerable and marginalized populations, as well as housing issues and the justice system.