Apr 09, 2008 - 05:55 AM

By Joanna Smith, Rob Ferguson / Torstar News Services

QUEEN'S PARK -- Health Minister George Smitherman said there will be no "blank cheque" to help hospitals facing staff and service cuts despite a storm that erupted yesterday over the loss of up to 72 nursing positions at two GTA hospitals.

"How can you justify the firing of nurses?" Progressive Conservative health critic Elizabeth Witmer thundered at Smitherman repeatedly in the Legislature's daily question period.

Smitherman said Rouge Valley Health System hospitals in Ajax and Scarborough planning to cut up to 220 jobs and close 36 beds cannot expect a bailout because they have been poorly run and exceeded their budget.

"I don't prefer that in any circumstance," he said of the cuts. "But the alternative is to have a free-for-all where hospitals spend whatever they want and send the bill at the end of the year. The people's health system can't be sustained on that basis."

Smitherman said any nurses that lose their jobs at the Ajax and Pickering hospital or Scarborough Centenary can expect to find work nearby as the government hires 9,000 more nurses by 2011.

A report released by the Canadian Institute for Health Information last November showed Rouge Valley had the fifth-highest mortality rate among hospitals in the GTA.

"You don't solve an issue as serious as this by cutting the number of RNs on staff," said Doris Grinspun, executive director of the Registered Nurses Association of Ontario. "You do the opposite."

NDP Leader Howard Hampton said the financial trouble hospitals are facing is in part due to millions of extra dollars going to build and expand hospitals with public-private partnerships that pay a premium to the builders.

"Less and less is going to patient care and more and more of the money is being siphoned off by profit-driven companies."

Ontario Health Coalition director Natalie Mehra criticized the level of secrecy surrounding the allocation of public money, especially since a large number of hospitals are threatened with deficits.

"This is really a regime of secrecy and top-down restructuring that is almost guaranteed to create significant problems in the health system for access and with no proper feedback group or evaluation," Mehra said. "It's really just bad governance."

Rouge Valley Health System is not alone in struggling to balance its books this spring to comply with zero-deficit legislation, but the answer to how many hospitals are in that situation is still unknown.

An Ontario Hospital Association survey conducted about a month ago as a pre-budget exercise revealed 75 Ontario hospitals forecast deficits for fiscal 2008/09. For fiscal 2009/10, that number increased to 103 of the 151 hospitals that responded to the survey.

Up to 19 hospitals in the GTA forecast deficits in 2008/09 and 26 in 2009/10.

Smitherman yesterday pointed to a recent peer review conducted by the Central East LHIN that concluded years of mismanagement and overspending had pushed Rouge Valley into its critical financial situation.

"There's room for improvement," said Smitherman, who has in previous years come through with year-end funds to help hospitals after weeks of rhetoric and wrangling.

"It wouldn't be fair to bail out Rouge Valley for activity that other hospitals are not involved in," he added. "I think the taxpayers are going to thank goodness, for once, there's a minister of health and a government that doesn't allow hospitals to operate on a blank cheque basis."

Ontario's health budget is now $40 billion and accounts for almost half of the government's spending on programs, with Premier Dalton McGuinty noting health spending is up 37 per cent since he took power in 2003.

Critics said Smitherman is ignoring the needs of hospitals in fast-growing areas.