Brampton Hallway Medicine letter

To Whom it may concern,

                                                   I am writing this as an official submission to the ministry of heath and long-term care to be part of the official Phase 2 Interim Report Hallway Health Care: A system Under Strain. I agree with the 3 key challenges the 1st report presents which are as follows:

·         Patients are waiting too long for care.
·         The system does not have the appropriate mix of services, beds, or digital tools to provide care where and when it is needed.
·         And there needs to be more effective coordination within the system to provide better value for taxpayer money.



When it comes to wait times for the patients that need admission in the hospital. Brampton is waiting an average of 18.4 -19.9 hours as compared to provincial average of 14.5 hours. It is the highest wait time in the province and the country. The need for more funding is dire, as highlighted by the report the need to fair access to health care across the province continues to be a concern. Brampton is the first place this concern should be addressed. The first phase of the report acknowledged that patients are waiting too long in a hallway. The situation in Brampton is one of the worst as stated by Dr. N Mohammed an emergency physician at Brampton Civic. His observations tell us that patients that visit the facility are older, sicker and are increasing in volume. He also adds that Brampton Civic continues to one of the busiest ER in the country. Ironically, it is one of the least funded and the least used hospital on a per capita basis but it remains the busiest . The usage of the facility is as efficient it can be thanks to effort of the frontline staff, but it shows clears sign of being over capacity for what it was designed for. This clearly shows the under investment in our city. His recommendation to solve the issue is to fund healthcare as per the population needs. He suggests creating a funding model that accounts for the level of volume a city is facing. In another interview he highlighted a need for a new space to provide care. Even with new investments in the past few years Brampton Civic hospital only saw patient volume in the ER go down about 10 days as Peel Memorial Hospital opened and the patient volume at Brampton Civic returned to the “very high level” and continues to remain so at present.

Second round funding for PMH [peel memorial hospital] for the 100 rehabilitation beds is a start and cannot wait and should go ahead with as it is needed immediately. This would add to the continuum of care services the province is looking to add to in the province. In addition, to the second-round funding, the province should work with William Osler and greenlight the third hospital. Brampton Civic’s Emergency was designed for 200 patients a day. It is currently taking 400-500 patients in the ER. This number is said to grow and if this situation is not addressed, fast track patients will spill over in the foyers and cafeteria. This is highly unacceptable and exactly the type of practices the province is trying to avoid. This is also one the 4-key theme highlighted in the first phase of the report. The four key themes have emerged through the Council’s initial work that will help guide the development of detailed recommendations in its next report:

1. A pressing need to integrate care around the patient and across providers in a way that makes sense in each of our communities in the province, and improves health outcomes for Ontarians.

2. Growing demand and opportunity to innovate in care delivery, particularly in the use of virtual care, apps, and ensuring patients can access their own health data.

3. The potential for greater efficiency in how we streamline and align system goals to support high quality care.

4. The critical role for a long-term plan so that we have right mix of health care professionals, services, and beds to meet our changing health care needs.



Specifically point 4, we need a long term plan. Brampton needs to start the construction of the third hospital to sustain the essential services our city requires to maintain a good quality of life and dignity and timely access to care we rightfully deserve.

If the council’s primary objective is to : help ensure Ontarians have a health care system that has the right mix of health care professionals, the right number of hospital and long-term care beds, and that care is available when and where it’s needed.   Brampton should be the starting point to transform the healthcare system as the province would like to do. To ensure the right mix of beds in Brampton would require a 3rd hospital one with a fully funded 24/7 emergency.



The report acknowledges capacity pressures: Capacity pressures are also contributing to the problem of hallway health care in Ontario. There are several causes to the capacity challenge:

1.       Ontario may not have the appropriate number of hospital, or long-term care beds to meet the health needs of the population;

Therefore, the solution in Brampton is another hospital. Even the to be announced Ontario Health teams cannot have no more than 300,000 people in one healthcare team. Even if province turns the two existing hospitals to separate health teams it cannot plan for the leftover population that need to be accounted for in an health team. The solution is to make a new hospital to provide the access of care for the present and the coming years. As Brampton is one the fastest growing cites in the country access to essential services like healthcare is needed to have a healthy workforce and better quality of life all Ontarians deserve.



Code Gridlock. It is a problem in Brampton Civic for years the underfunding in our healthcare is the reason why this problem continues to grow. Our healthcare professionals provide world class care in sub optimal spaces. In the last year Brampton Civic Hospital was in code gridlock more than 100 days. One of the highest days experienced at any hospital in the province. Code Gridlock entails patients receiving the care that the emergency department is mandated to provide them and are waiting for another department to admit them to receive further care. Brampton is the lowest funded healthcare city as per its healthcare needs. Currently Brampton receives $611.35 per capita. Compare that to a neighboring city Mississauga, which receives 869.86 per capita. Hamilton a city half of size in population receives $1414.56. Such discrepancy in funding has resulted in the poor health outcomes citizens of Brampton have experienced over the years. It needs to stop. The city has no creative flexibility left to create a new healthcare provision model with such low healthcare dollar allocation as per its needs. Consider the metrics and evidence known to the government to make evidence-based policy to meet the needs of our city.

The first phase of the report stated: The Council will consider strategies that include prevention, early intervention, and evidence-based programs that improve health outcomes, and will look at best-practices in Ontario and in other jurisdictions across the world as it develops advice for government

The council should consider coming to Brampton Civic as part of Phase 2 to gather the primary information it needs to make evidence-based decisions. Although the province has enough evidence to realize that access to healthcare in Brampton needs to be at par with rest of Ontario. Investing in Brampton is the only solution, allowing Bramptonians to be involved in that process by bringing the consultation to our city shows a step in the right direction.

In Summary: come to Brampton as part of the in person consultation, create a funding model that should reflect the population growth of our city and acknowledge the underinvestment in Brampton over the years. 2nd round funding of Peel Memorial Hospital and most importantly a third hospital with a fully funded 24/7 emergency designed to meet the current and future needs of our city as per our population to bring the level of health care access at par with rest of Ontario. The healthcare teams that keep primary care in mind can also reduce the incidence of chronic conditions and diseases with culturally appropriate care and population specific interventions needed to address co morbidities like type 2 diabetes which Brampton needs to address as a community.

Sincerely,