Toronto hospital crisis

The Toronto hospital crisis amplified, and was amplified by, the Toronto SARS crisis. Both are part of a more general Toronto respiratory health crisis. The hospital component dates back to the mid-1990s when hospital services in downtown Toronto were "consolidated" as a "money-saving" measure that made "economic sense". At this time various community institutions, e.g. Toronto Women's College Hospital serving women's health needs, Wellesley Hospital serving the downtown gay community, were closed. A series of confrontations and restrictive labour measures applied by the Progressive Conservative Party of Ontario government of Premier Michael Harris (and later Ernest Eves of the same Party) were part of a general strategy of that government to "create a crisis" as they had done in education previously. Early warning and community health systems were dismantled, despite frequent warnings of dangers. As characterized in a 2003 letter sent to the World Health Organization by an Ontarian with direct experience with the regime:

"The Provincial government does not appear to understand the systemic relationships between its health care, education, and social assistance systems. Consequently, it has made policy decisions resulting in unanticipated increases in demand for health services."

For example, Ontario repeatedly over-ruled smog control measures advised and taken by officials in Toronto, such as laws against truck idling, or transit expansion to remove cars from the streets. See Toronto smog crisis. This increased car accidents, asthma, bronchitis, and other acute illnesses - further loading the hospital system and causing shortages of medical labour:

"We often find ourselves short of professionals to do the work needed in our health care system... we are terribly short of nurses, family doctors, and specialist doctors. In particular, we are dreadfully in need of psychiatrists. There are many people walking the streets of our community who need regular follow-up with a psychiatrist who simply don't get it until their cases demand hospitalization for acute episodes. I'm sure you can imagine the public health implications of having people struggling to function on the streets."

The reference to "people walking the streets" seems to refer also to the Toronto housing crisis which, along with the Toronto smog crisis, drastically increased the vulnerability of Toronto citizens and reduced the flexibility and spare capacity of the hospital system. This drastically increased the overall impact of the Toronto SARS crisis, which caused many surgeries to be delayed, and infected dozens of health care workers, causing even more shortages. This was the intersection (and hopefully culmination) of the more general Toronto respiratory health crisis and the global SARS epidemic, which was handled in quite different ways in China and in Canada.