Councillors approved slate of recommendations for hospital alliance funding, including proposal to limit funding to hospitals located within Simcoe County
Simcoe County is being urged to overhaul how it funds local hospitals following a year‑long review of the Simcoe County Hospital Alliance (SCHA).
The review, completed by Ernst & Young LLP (E&Y) and presented to councillors during Tuesday’s committee of the whole meeting, found the region needs “a more coordinated and structured approach to hospital capital planning” to keep pace with rapid population growth and rising infrastructure demands.
It also recommends the county push the province for sweeping reforms to Ontario’s capital funding system.
Jane Sinclair, the county’s general manager of health and emergency services, said the accounting firm was hired through council direction about a year ago.
“The county, of course, has been a longtime supporter of our local hospitals and we have been hearing of late the increased pressures associated with increased capital costs for our hospital partners,” she said, adding E&Y was asked to identify opportunities for increased efficiencies, effectiveness and provincial advocacy.
The alliance is made up of Royal Victoria Regional Health Centre (RVH) in Barrie, Orillia Soldiers’ Memorial Hospital, Collingwood General & Marine Hospital, Georgian Bay General Hospital in Midland/Penetanguishene, Stevenson Memorial Hospital in Alliston, Waypoint Centre for Mental Health Care in Penetanguishene, and Southlake Health in Newmarket.
The final report includes six recommendations for the county and five areas for provincial capital‑funding advocacy, which E&Y says would “support improved alignment between capital investments, service needs and population growth across Simcoe County.”
The county currently allocates $3 million annually to the SCHA under a 15‑year, $45‑million policy that runs until 2031. Local hospital leaders told the firm the funding has not kept pace with inflation or the scale of modern capital projects, which now range from tens of millions to multibillion‑dollar builds.
Alliance members also urged the county to stop funding hospitals outside Simcoe County, such as Southlake Health in York Region, arguing dollars should be redirected to local expansion projects.
That suggestion drew pushback from at least one councillor.
Bradford West Gwillimbury Mayor James Leduc questioned the recommendation and attempted to remove it from the motion, though his amendment was defeated.
“It’s very difficult for me to sit here and say to the residents in the southern portion of the county that we are not going to help support Southlake, even though they provide major services to many residents,” he said. “For us to sit here and put a message out there that we are going to do a marketing share plan in the sense that we are going to only market within our own border, doesn’t make sense to me.
“I fully support some of the recommendations in there, but I have a real problem with (the second recommendation),” Leduc added.
The firm proposed six changes to the county’s funding policy:
Integrated regional planning — requiring hospitals to participate in a coordinated planning process
Local‑only funding — limiting county dollars to hospitals physically located in Simcoe County
Non‑clinical space limits — restricting funding for non‑clinical areas
Community health key performance indicators (KPIs) — to reduce pressure on acute care
Standardized growth forecasting — across all hospital partners
Potential funding increase — reviewing the current $3‑million annual contribution.
The firm also recommended the county advocate for five provincial reforms, including exploring hospital amalgamation — similar to Niagara Health or the new Waterloo Regional Health Network — and revising the Information, Communications and Automation Technology (ICAT) cost‑sharing model, which hospitals say is outdated and inequitable.
Other provincial recommendations include shifting toward regional capital planning, requiring municipalities to be consulted during site selection and adopting more advanced analytical tools.
Babek Aghdaee, a partner in E&Y’s infrastructure advisory practice, stressed that amalgamation refers to planning, not closures.
“We are not saying something has to be amalgamated. This is not the nature of the recommendation,” he said, noting that in the examples cited, hospitals “form the planning function and the capital function combine.”
“It doesn’t mean any service is being eliminated. It doesn’t mean any hospital is not going to serve the residents,” Aghdaee added. “It’s a central function that thinks about what can be done and where it can be done at the most efficient level. Amalgamation is around the amalgamation of thinking and planning, not closure and amalgamation of the actual facilities.”
Adjala‑Tosorontio Mayor Scott W. Anderson argued the county should avoid provincial‑level advocacy.
“The hospitals, directly, need to be involved in that,” he said, adding the program was created to support local community shares, not to “overstep bounds with the provincial government.”
“This is to help our local hospitals fund their community share and our community programs. That’s what this policy needs to reflect,” Anderson said.
Penetanguishene Mayor Doug Rawson acknowledged the complexity of health care and the growing capital pressures facing local hospitals.
“We are all faced with impossible challenges and I know locally hospitals are telling us they’re having a hard time meeting their capital demands,” he said. “This isn’t about one hospital being better than another. It’s about how we can have a bigger impact.”
He disagreed with Leduc’s concerns about Southlake.
“This is not about Southlake or what they do or don’t do. This is about who we can help,” Anderson said. “Every time we say yes to something, we have to say no to something else.”
Rawson noted county residents use hospitals across the province, but considering all of them “will only serve to complicate the issue.”
“Our local hospitals say they need help and we need to look at where we can have the biggest impact,” he said.
Council ultimately approved the recommendations as presented.
County staff will now revise the SCHA funding policy and report back on potential increases to annual hospital funding.
The warden will also write to the provinvce’s health minister advocating for changes to Ontario’s capital funding program.